ORIGINAL_ARTICLEMolecular Involvement and Prognostic Importance of Fms-like Tyrosine Kinase 3 in Acute Myeloid LeukemiaAML (Acute myeloid leukemia) is a form of blood cancer where growth of myeloid cells occurs in the bonemarrow. The prognosis is poor in general for many reasons. One is the presence of leukaemia-specific recognitionmarkers such as FLT3 (fms-like tyrosine kinase 3). Another name of FLT3 is stem cell tyrosine kinase-1 (STK1),which is known to take part in proliferation, differentiation and apoptosis of hematopoietic cells, usually beingpresent on haemopoietic progenitor cells in the bone marrow. FLT3 act as an independent prognostic factor forAML. Although a vast literature is available about the association of FLT3 with AML there still is a need of abrief up to date overview which draw a clear picture about this association and their effect on overall survival.http://journal.waocp.org/article_26828_7c8cb1fd423f85835f23be30a5e00c31.pdf2012-09-01T11:23:202017-12-14T11:23:2042154220AMLFLT3ITDs(TKD)leukemia-specific recognition markersprognostic markerORIGINAL_ARTICLECurrent Status of Knowledge, Attitude and Practice (KAP) and Screening for Cervical Cancer in Countries at Different Levels of DevelopmentCancer of the uterine cervix is a worldwide menace taking innumerable womens’ lives. The literature is vastand a large number of studies have been conducted in this field. Analyses have shown significant differencesexist in terms of screening and HPV testing facilities among high income and low to middle income countries. Inaddition, acute lack of awareness and knowledge among the concerned population is particularly noted in ruralareas of the low income countries. A detailed review of Indian case studies revealed that early age of marriageand childbirth, multiparity, poor personal hygiene and low socio-economic status among others are the principalrisk factors for this disease. This review concludes that a two pronged strategy involving strong government andNGO action is necessary to minimize the occurrence of cervical cancer especially in low and medium incomecountries.http://journal.waocp.org/article_26829_889fdc6bf985dcafd3503bdd1a914bdd.pdf2012-09-01T11:23:202017-12-14T11:23:2042214227Cervical cancer - pap smear - HPV- risk factors &#8211KAP - country income levelsORIGINAL_ARTICLEOmics of CancerWith the advances in modern diagnostic expertise for cancer, certain approaches allowing scanning of thecomplete genome and the proteome are becoming very useful for researchers. These high throughput techniqueshave already proven power, over traditional detection methods, in differentiating disease sub-types and identifyingspecific genetic events during progression of cancer. This paper introduces major branches of omics-technologyand their applications in the field of cancer. It also addresses current road blocks that need to be overcome andfuture possibilities of these methods in oncogenic detection.http://journal.waocp.org/article_26830_b6fb4b749c67b27b6a0c4fb7edd7bba4.pdf2012-09-01T11:23:202017-12-14T11:23:2042294233GenomicsproteomicsepigenomicstranscriptomicsORIGINAL_ARTICLEReliability and Validity of the Quality of Life –Family Version (QOL-FV) in Turkish Family Caregivers of Patients with CancerObjectives: Family caregivers (FCs) are often the primary source of social and emotional support for cancerpatients and play a major role in how well they manage their illness. The aim of this study was to create an Turkishversion of the Quality of Life - Family Version (QOL-FV) and to evaluate its psychometric properties in a sampleof FCs of cancer patients. Materials and Methods: This study was carried out with the FCs of 218 patients withcancer. Data were collected with a Demographic Questionnaire and the QOL-FV and The Multidimentional Scaleof Perceived Social Support (MSPSS). The QOL-FV was developed by Ferrell and Grant and is composed of 4subdimensions. Linguistic validity, translation, back translation, and content validity were tested with expertopinions. Test-retest reliability, and internal consistency reliability were assessed. Construct validity was testedby factor analysis and with the scale of the MSPSS. Results: The family caregivers were between the ages of46-56 (32.6%), a great number of them being male (52.8%). The scale is made up of four subdimensions. Theresult of the test-retest analysis of this scale was calculated as r:0.86. As a result of the reliability analysis, sixitems were eliminated from the scale, factor analyses were fulfilled according to varimax transformation throughthe method of principal components. Four new subdimensions were restrustured at the end of the analysis. Thescale of Cronbach α coefficient was calculated as 0.90. Concurrent validity showed low correlations with theMSPSS (r=0.29). Conclusions: The QOL-FV, adapted into Turkish, was found to have sufficient reliability andvalidity.http://journal.waocp.org/article_26831_05e6af403439a080e05e1c8073135bfb.pdf2012-09-01T11:23:202017-12-14T11:23:2042354240Quality of life questionnaireReliabilityValiditycancerTurkish family caregiversORIGINAL_ARTICLESerum Kynurenic Acid: Possible Association with Invasiveness of Non-small Cell Lung CancerThe lung adenocarcinoma is considered more aggressive than other types of non-small cell lung cancer. Asmetabolites of tryptophan degradation along the kynurenine pathway, including kynurenic acid, have been shownto induce immunosuppression and facilitate escape of tumor cells from immune surveillance, a hypothesis was setup that differences in biological behavior between types of lung cancer may be associated with altered activity ofthe kynurenine metabolic pathway. The aim of the study was to determine kynurenic acid levels in the serum ofpatients with bronchial adenocarcinoma for comparison with other types of non-small cell lung cancer. A totalof 227 patients with non-small cell lung cancer were enrolled in the study, including 71 with adenocarcinomaand 96 with squamous cell carcinoma. Serum kynurenic acid concentration was determined with use of highperformance liquid chromatography and fluorometry. The level of kynurenic acid in the serum of patients withadenocarcinoma was significantly higher than in those with squamous cell lung cancer (107.1 ± 62.8 pmol/ml;95%CI: 92.4 to 132.3 pmol/ml versus 82.1 ± 47.6 pmol/ml; 95%CI: 78.5 to 91.2 pmol/ml, respectively; p = 0.027).Differences between other histological types of lung cancer were insignificant. We conclude that increased activityof kynurenine metabolic pathway manifested by elevated serum kynurenic acid level may be one of the factorsassociated with clinically distinct biological behavior of adenocarcinoma, in particular high invasiveness andrapid progression.http://journal.waocp.org/article_26832_f88629de0c63c61ea8962795db421a80.pdf2012-09-01T11:23:202017-12-14T11:23:2042414244Lung cancerkynurenineAntiproliferativekynurenic acidinvasivenessORIGINAL_ARTICLEPrevalence of Smoking among Female Medical Students in Saudai ArabiaBackground: Women make up half of the world’s population, and comprise 20% of the world’s one billionsmokers. The aim of this study was to assess the prevalence of smoking among female medical students incomparison to female non-medical students, and to assess the importance of medical education and knowledgein decreasing the prevalence of smoking among female university students in Saudi Arabia. Method: We useda self-administered questionnaire to collect cross-sectional data from a randomly selected sample of 320 femalestudents attending King Abdul-Aziz University, Jeddah. Medical students comprised 50% of the sample. Results:A total of 310 students (96.9%) completed and returned the questionnaire. The prevalence of smoking was higherin non-medical female students (4.2%) compared to medical female students (0.32%) (P < 0.001). Conclusion:The prevalence of smoking is low among female medical students compared to female non-medical students,presumably because of their awareness, level of education, and knowledge of the risks to health associated withsmoking. Our study highlights the need for increased knowledge, health education, and awareness of the risksof smoking to reduce smoking among female university students.http://journal.waocp.org/article_26833_fbf9bce498e9e2a2f35ec5844ae5ad34.pdf2012-09-01T11:23:202017-12-14T11:23:2042454248SmokingPrevalencemedical studentseducationsmoking risksSaudi ArabiaORIGINAL_ARTICLEAssociation between Trace Element and Heavy Metal Levels in Hair and Nail with Prostate CancerWhile associations between trace elements and heavy metals with prostate cancer are still debatable, theyhave been considered as risk factors for prostate cancer. Thus, this study aimed to detect any links betweenselected minerals and heavy metals including Se, Zn, Cu, Mn and Fe with prostate cancer. A case control studywas carried out among 100 subjects (case n=50, control n=50), matched for age and ethnicity. Trace elementsand heavy metals level in hair and nail samples were determined by ICP-MS. Mean selenium levels in hair andnail of the cases were significantly lower as compared to controls. A similar trend was noted for zinc in bothhair and nail samples, whereas the mean level of copper was significantly higher in cases than controls. Similarelevation was noted for iron and manganese (p<0.05 for all parameters). Low levels of selenium and zinc andhigh levels of copper, iron and manganese appear to be associated with the risk of prostate cancer. Furtherstudies to elucidate the causal mechanisms and appropriate chemopreventive measures are needed.http://journal.waocp.org/article_26834_d970859b93181569ebb0a72bf524e731.pdf2012-09-01T11:23:202017-12-14T11:23:2042494253Prostate CancerHeavy metalsTrace Elementshair and nail samplescase-control studyORIGINAL_ARTICLERadioimmunoimaging with Mixed Monoclonal Antibodies of Nude Mice Bearing Human Lung Adenocarcinoma XenograftsThe present study was conducted to evaluate radioimmunoimaging (RII) and in vivo distribution of mixedantibodies 99mTc-EGFR-mAb and 99mTc-CD44- mAb in nude mice bearing human lung adenocarcinoma xenografts.Single and mixed applications of the two radiolabeled monoclonal antibodies (mAbs) were compared. Directlabeling of 99mTc was applied to radiolabel the EGFR and CD44 mAbs. The properties of the radiolabeledantibodies were then characterized. RII and assessment of the distribution of the antibodies in nude mice bearinglung adenocarcinoma xenografts were achieved by applying separate and combined doses of 99mTc-EGFR-mAband 99mTc-CD44-mAb. The labeling rates of 99mTc for EGFR-mAb and CD44-mAb were 91.5% ± 3.8% and 92.3%± 4.1% respectively, with specific activities of 2.8 and 2.9 MBq/μg, respectively, and radiochemical purities (RCP)of 96.5% and 96.2%. The radioactivity uptake of the combined application of both radiolabeled antibodieswas clearly higher than with a single application of either alone. The relative values of target-to-nontarget (T/NT) measured through the regional interest (ROI) technique were 5.59 ± 0.42 (mixed antibodies), 2.78 ± 0.20(99mTc-EGFR-mAb), and 2.28 ± 0.16 (99mTc-CD44-mAb) in the RII. The body distribution of the radiolabeledantibodies and their imaging results were basically identical. Application of the mixed antibodies with 99mTc-EGFR-mAb and 99mTc-CD44-mAb can increase the radioactivity uptake of tumor tissue, leading to more idealtarget-to-nontarget ratios, and therefore superior results.http://journal.waocp.org/article_26835_1e901cd4322252d254b6d6137c9d34c1.pdf2012-09-01T11:23:202017-12-14T11:23:2042554261EGFRCD44radioimmunoimagingmolecular imagingmonoclonal antibodyORIGINAL_ARTICLEA GFP-labeled Human Colon Cancer Metastasis Model Featuring Surgical Orthotopic ImplantationColorectal cancer has become a major disease threatening human health. To establish animal models thatexhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying thegenesis and development effectively, but also provide ideal carriers for the screening of medicines and examiningtheir therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressinggreen fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFPlabeledcolon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and therewere no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed inall model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at thesame time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice diedand the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth.Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesentericlymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeledcolon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibitsimilar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive anddynamic observation and analysis of the growth and metastasis of tumor cells.http://journal.waocp.org/article_26836_1e5824796522cee302ce2bc50fd92b15.pdf2012-09-01T11:23:202017-12-14T11:23:2042634266Colon cancerFluorescencesurgical orthotopic implantationmetastasisORIGINAL_ARTICLEAcceptance of Human Papillomavirus Vaccine by Adolescent Girls and Their Parents in TurkeyPurpose: The aim of this study was to identify the opinions of Turkish adolesecent girls and their parentsabout HPV vaccination and the consistency. Methods: This descriptive study covered 301 girls and their parents.Questionnares were developed by the researchers based on findings within the literature and applied for datacollection. Results: The mean age was 19.4 for girls, 44.2 for mothers and 47.9 for fathers. It was found that 43.5percent of girls and 31.9 percent of mothers wish to be vaccinated against HPV. Also, 45.5 percent of mothersand 44.9 percent of fathers wish for their daughters to be vaccinated against HPV. A moderate consistency wasfound between mothers and fathers; a low consistency was found between fathers and girls, and between mothersand girls. Conclusions: The study indicates that an appropriate background has been partially provided aboutthe acceptability of the vaccine between parents and their daughters in Turkey. However, the vast majority ofadolescent girls and parents are indecisive or reluctant about HPV vaccination. This study also showed that thedecisions of adolescents about vaccination may be affected by the opinions of the parents.http://journal.waocp.org/article_26837_7e10d5c16fb8c3d4c386239dd1f9a633.pdf2012-09-01T11:23:202017-12-14T11:23:2042674272Adolescent girlsconsistencyHuman Papilloma VirusParentsTurkeyORIGINAL_ARTICLEBreast, Cervical, and Colorectal Cancer Screening Status of a Group of Turkish WomenIntroduction: The aim of the study was to determine the breast, cervical, and colorectal cancer screeningrates and the influencing factors in a group of Turkish females. Methods: This descriptive study was conductedin a School of Nursing. The study sample consisted of 603 females who were the mothers/neighbors or relativesof the nursing students. Data collection forms were developed by the investigators after the relevant literaturewas screened and were used to collect the data. Results: Of the women aged 30 and over, 32.8% had undergonea pap smear test at least once in their life. Of those aged 50 and over, 48.2% had undergone mammography atleast once and FOBT had been performed in 12% of these women in their life. Having heard of the screeningtests before, knowing why they are done, and having information on the national cancer screening programwere important factors influencing the rates of women having these tests done. Discussion: The results of thisstudy show that the rates of women participating in national cervical, breast, and colorectal cancer screeningprograms are not at the desired levels. Having heard of the screening tests before, knowing why they are done,and having information on the national cancer screening program were important factors influencing the ratesof women having these tests done. It is suggested that written and visual campaigns to promote the service shouldbe used to educate a larger population, thus increasing the participation rates for cancer screening programs.http://journal.waocp.org/article_26838_3c5fe5de7a3ba855ffc04b27f6aa7719.pdf2012-09-01T11:23:202017-12-14T11:23:2042734279Cancer screeningBreast cancercervical cancercolorectumTurkish womenFactorsORIGINAL_ARTICLEIncidence and Survival Rates among Pediatric Osteogenic Sarcoma Cases in Khon Kaen, Thailand, 1985-2010Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate ofamputation and death. This is the first long-term, population-based, epidemiologic and survival study inThailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen.Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The datawere retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical recordsfrom Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the endof April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survivalexperience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meiercurve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equallyaffected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 infemales). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer(5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhoodosteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower thanreports from developed countries. Further evaluation of the treatment protocol and risk factor stratification isneeded.http://journal.waocp.org/article_26839_a6fa955987778b07ec1182a801465cb0.pdf2012-09-01T11:23:202017-12-14T11:23:2042814284ORIGINAL_ARTICLECommunity-Based Cross-Sectional Study of Carcinogenic Human Liver Fluke in Elderly from Surin Province, ThailandBackground: Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia. It isassociated with a number of hepatobiliary diseases and the evidence strongly indicates that liver fluke infection isthe etiology of cholangiocarcinoma. Objectives: This study aimed to determine Opisthorchis viverrini infection inelderly people in Surin province, Northeastern Thailand. Methods: A community-based cross-sectional survey wasconducted among 333 elderly in 17 districts of Surin province, during one year period from January to December2011. O. viverrini infection was determined using Kato’s Thick Smear technique and socio-demographic werecollected using predesigned semi-structured questionnaires, respectively. Results: A total of 333 elderly including116 males and 217 females were selected from different study sites. Overall intestinal parasitic infection was16.2%, predominantly in O. viverrini (9.91%) and followed by Strongyloides stercolaris (4.80%) and hookworm(1.50%), respectively. The O. viverrini infection was found higher in males (13.8%) than females (7.83%), andfrequently in elderly 60-70 year old with 14.2%. Chi-square testing indicated that education and occupationwere significantly associated with O. viverrini infection (P value = 0.02). The distribution of O. viverrini infectionwas found in 11 districts which was covered 64.7% of the studies areas. The highest prevalence was found inThatum with 39.1%, and followed by Sangkha (24.0%), Buachet (21.1%), Samrong Thap (19.1%), Si Narong(15.0%), and Ratanaburi (13.3%) districts. Conclusion: This findings stress that O viverrini is still a problemin Thailand. We confirmed, for the first time, the high endemicity of human O. viverrini infections in elderly inSurin province of Thailand, underlying the fact that mass treatment and health education are urgently required.http://journal.waocp.org/article_26840_586d15f1732f8aed10f117e917fa150a.pdf2012-09-01T11:23:202017-12-14T11:23:2042854288Carcinogenic human liver flukeOpisthorchis viverriniSurinThailandORIGINAL_ARTICLEUnderstanding Breast Cancer Screening Practices in Taiwan: a Country with Universal Health CareWhile the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidlyin Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women.Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening amongChinese women. The aim of this study is to assess Taiwanese women’s knowledge of and attitudes toward BCscreening and to identify potential factors the may influence screening behavior. The study population consistedof a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanesewomen and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinicalbreast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, themajority of women had never had mammograms or ultrasound in the past 5 years. The number one most reportedbarriers were “no time,” “forgetfulness,” “too cumbersome,” and “laziness,” followed by the perception of noneed to get screened. In addition, the results revealed several areas of misconceptions or incorrect informationperceived by study participants. Based on the results from the regression analysis, significant predictors ofobtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention,family/friends diagnosed with breast cancer. The findings from the current study provide the potential to buildevidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancerand promote BC screening in order to optimize health outcomes for women affected by this disease.http://journal.waocp.org/article_26841_981c8608271d1274c3a8dd00650940e2.pdf2012-09-01T11:23:202017-12-14T11:23:2042894294Bresst self-examclinical breast-examMammographyTaiwanORIGINAL_ARTICLEHuman Embryonic Stem Cells - a Potential Vaccine for Ovarian CancerObjective: To investigate the therapeutic potential of human embryonic stem cells (hESCs) as a vaccine toinduce an immune response and provide antitumor protection in a rat model. Methods: Cross-reactivity ofantigens between hESCs and tumour cells was screened by immunohistochemistry. Fischer 344 rats were dividedinto 7 groups, with 6 rats in each, immunized with: Group 1, hESC; Group 2, pre-inactivated mitotic NuTu-19;Group 3 PBS; Group 4, hESC; Group 5, pre-inactivated mitotic NuTu-19; Group 6, PBS; Group 7, hESC only.At 1 (Groups 1-3) or 4 weeks (Groups 4-6) after the last vaccination, each rat was challenged intraperitoneallywith NuTu-19. Tumor growth and animal survival were closely monitored. Rats immunized with H9 and NuTu-19 were tested by Western blot analysis of rat orbital venous blood for cytokines produced by Th1 and Th2 cells.Results: hESCs presented tumour antigens, markers, and genes related to tumour growth, metastasis, and signalpathway interactions. The vaccine administered to rats in Group 1 led to significant antitumor responses andenhanced tumor rejection in rats with intraperitoneal inoculation of NuTu-19 cells compared to control groups.In contrast, rats in Group 4 did not display any elevation of antitumour responses. Western blot analysis foundcross-reactivity among antibodies generated between H9 and NuTu-19. However, the cytokines did not showsignificant differences, and no side effects were detected. Conclusion: hESC-based vaccination is a promisingmodality for immunotherapy of ovarian cancer.http://journal.waocp.org/article_26842_33efc6a544c7c55f260de1e48e859237.pdf2012-09-01T11:23:202017-12-14T11:23:2042954300ovarian cancerhuman embryonic stem cellantitumor immunitycancer vaccineORIGINAL_ARTICLEConcurrent Weekly Cisplatin Versus Triweekly Cisplatin with Radiotherapy in the Treatment of Cervical Cancer: A Metaanalysis ResultAims: To evaluate the adverse effect and survival outcome of weekly and triweekly cisplatin with radiotherapyin treatment of cervical cancer. Methods: After an extensive literature search between 1995-2011,we analyzed7 studies to compare weekly cisplatin and triweekly cisplatin combined radiotherapy. Results: Our analysisestablished that weekly cisplatin has a lower risk of hematologic toxicity than triweekly cisplatin with concurrentradiotherapy in the treatment of cervical cancer. However, there were no differences in progression free survivaland overall survival between weekly cisplatin and triweekly cisplatin (p>0.05). Conclusions: Weekly cisplatincombined with concurrent radiation has lower risk in hematologic toxicity than triweekly cisplatin, but does notimprove survival. Triweekly cisplatin treatment has longer intervals and is therefore more convenient. Cliniciansand patients can choose either weekly cisplatin or triweekly cisplatin combined radiotherapy for cervical cancer.http://journal.waocp.org/article_26843_900ad9a447487d8d2cde6de76a53a25a.pdf2012-09-01T11:23:202017-12-14T11:23:2043014304cisplatincervical cancerweeklytriweeklyChemoradiationORIGINAL_ARTICLEAssociation Between TP53 Arg72Pro Polymorphism and Hepatocellular Carcinoma Risk: A Meta-analysisBackground: Previous studies on the association between the TP53 Arg72Pro polymorphism and hepatocellularcarcinoma (HCC) risk obtained controversial findings. This study aimed to quantify the strength of theassociation by meta-analysis. Methods: We searched PubMed and Wangfang databases for published studieson the association between the TP53 Arg72Pro polymorphism and HCC risk, using the pooled odds ratio (OR)with its 95% confidence intervals (95% CI) for assessment. Results: 10 studies with a total of 2,026 cases and2,733 controls were finally included into this meta-analysis. Overall, the TP53 Arg72Pro polymorphism wasnot associated with HCC risk (all P values greaterth HCC risk in Caucasians in three genetic models (For Proversus Arg, OR = 1.20, 95%CI 1.03-1.41; For ProPro versus ArgArg, OR = 1.74, 95%CI 1.23-2.47; For ProProversus ArgPro/ArgArg, OR = 1.85, 95%CI 1.33-2.57). However, there was no significant association betweenthe TP53 Arg72Pro polymorphism and HCC risk in East Asians (all P values greater than 0.10). No evidenceof publication bias was observed. Conclusion: Meta-analyses of available data suggest an obvious associationbetween the TP53 Arg72Pro and HCC risk in Caucasians. However, the TP53 Arg72Pro polymorphism mayhave a race-specific effect on HCC risk and further studies are needed to elucidate this possible effect.http://journal.waocp.org/article_26844_51ccbe76308565874b6999c22b88273e.pdf2012-09-01T11:23:202017-12-14T11:23:2043054309Hepatocellular carcinomaTP53 Arg72ProPolymorphismMeta-analysisEthnicityORIGINAL_ARTICLEPosttraumatic Growth and Social Support in Turkish Patients with CancerPosttraumatic growth (PTG) is the experience of positive change that occurs as a result of the struggle withhighly challenging life crises. The need to understand PTG in relation to actual changes in an individual’s life hasrecently been raised. Little is known about the role of social support in the experience of positive outcomes. Thepurpose of this study is to investigate the role of perceived social support in enhancing PTG in cancer patients.This study involved 105 cancer patients. The data were collected using a questionnaire that determined thesocio-demographic features, posttraumatic growth inventory (PTGI) and perceived social support. Participantsreported relatively high levels of PTG and social support. Total perceived social support, support from family, andfriends were significantly positive associated with the development of PTG among cancer patients. Accordingly,the social surroundings of the patient should be informed about the importance of social support and how ithelps the patient; they should be made aware of necessity of social support.http://journal.waocp.org/article_26845_d456d150201855d481cb1e6dff93321e.pdf2012-09-01T11:23:202017-12-14T11:23:2043114314cancerOncologypost-traumatic growthpositive life changesocial supportTurkeyORIGINAL_ARTICLEMDM2 T309G has a Synergistic Effect with P21 ser31arg Single Nucleotide Polymorphisms on the Risk of Acute Myeloid LeukemiaBackground: The P53 tumor suppressor gene plays a pivotal role in maintaining cellular homeostasis bypreventing the propagation of genome mutations. P53 in its transcriptionally active form is capable of activatingdistinct target genes that contribute to either apoptosis or growth arrest, like P21. However, the MDM2 gene isa major negative regulator of P53. Single nucleotide polymorphisms (SNP) in codon Arg72Pro of P53 results inimpairment of the tumor suppressor activity of the gene. A similar effect is caused by a SNP in codon 31 of P21.In contrast, a SNP in position 309 of MDM2 results in increased expression due to substitution of thymine byguanine. All three polymorphisms have been associated with increased risk of tumorigenesis. Aim of the study:We aimed to study the prevalence of SNPs in the P53 pathway involving the three genes, P53, P21 and MDM2,among acute myeloid leukemia (AML) patients and to compare it to apparently normal healthy controls forassessment of impact on risk. Results: We found that the P21 ser31arg heterozygous polymorphism increasesthe risk of AML (P value=0.017, OR=2.946, 95% CI=1.216-7.134). Although the MDM2 309G allele was itselfwithout affect, it showed a synergistic effect with P21 ser/arg polymorphism (P value=0.003, OR= 6.807, 95%CI= 1.909-24.629). However, the MDM2 309T allele abolish risk effect of the P21 polymorphic allele (P value=0.71). There is no significant association of P53 arg72pro polymorphism on the risk of AML. Conclusion: Wesuggest that SNPs in the P53 pathway, especially the P21 ser31arg polymorphism and combined polymorphismsespecially the P21/ MDM2 might be genetic susceptibility factors in the pathogenesis of AML.http://journal.waocp.org/article_26846_5827d320d2219cc5b2051cda910c3b85.pdf2012-09-01T11:23:202017-12-14T11:23:2043154320single nucleotide polymorphismAcute Myeloid Leukemiap53p21MDM2ORIGINAL_ARTICLEAwareness of General Public Towards Cancer Prostate and Screening Practice in Arabic Communities: a Comparative Multi-Center StudyThe current study aimed at exploring the knowledge and beliefs of men aged forty years and over towardsprostate cancer screening and early detection in three Arab countries. The field work was conducted in threecountries; Saudi Arabia, Egypt and Jordan, during the period February through December 2011. Our targetpopulation were men aged 40 years and over. It was a population-based cross sectional study comprising 400subjects at each site. In addition to socio-demographic data, history of the present and past medical illness,practice history of prostatic cancer examination, family history of cancer prostate; participants were inquiredabout their knowledge and attitude towards prostate cancer and screening behavior using two different likertscales. The percentage of participants who practiced regular prostate check up ranged from 8-30%. They hadpoor knowledge and fair attitude towards prostate cancer screening behavior, where the mean total knowledgescore was 10.25±2.5, 10.76±3.39 and 11.24±3.39 whereas the mean total attitude score was 18.3±4.08, 20.68±6.4and 17.96±5.3 for Saudi Arabia, Egypt and Jordan respectively. The respondents identified the physicians as themain sources of this information (62.4%), though they were not the main motives for regular checkup. Knowledgewas the only significant predictor for participants’ attitude in the multiple regression models. Participants’attitudes depends mainly on level of knowledge and quantity of information provided to the patients and theirfamilies. Such attitudes should rely on a solid background of proper information and motivation from physiciansto enhance and empower behaviors towards prostate cancer screening practices.http://journal.waocp.org/article_26847_9cb90a7632a5d9b447dc327244859895.pdf2012-09-01T11:23:202017-12-14T11:23:2043214326Cancer prostate screeningknowledgeAttitudeearly detectionArab countriesORIGINAL_ARTICLEMeta-analysis of Associations between the MDM2-T309G Polymorphism and Prostate Cancer RiskThe mouse double minute 2 (MDM2) gene plays a key role in the p53 pathway, and the SNP 309T/G singlenucleotidepolymorphism in the promoter region of MDM2 has been shown to be associated with increased riskof cancer. However, no consistent results were found concerning the relationships between the polymorphismand prostate cancer risk. This meta-analysis, covering 4 independent case-control studies, was conducted tobetter understand the association between MDM2-SNP T309G and prostate cancer risk focusing on overall andsubgroup aspects. The analysis revealed, no matter what kind of genetic model was used, no significant associationbetween MDM2-SNP T309G and prostate cancer risk in overall analysis (GT/TT: OR = 0.84, 95%CI = 0.60-1.19;GG/TT: OR = 0.69, 95%CI = 0.43-1.11; dominant model: OR = 0.81, 95%CI= 0.58-1.13; recessive model: OR =1.23, 95%CI = 0.95-1.59). In subgroup analysis, the polymorphism seemed more likely to be a protective factorin Europeans (GG/TT: OR = 0.52, 95%CI = 0.31-0.87; recessive model: OR = 0.58, 95%CI = 0.36-0.95) thanin Asian populations, and a protective effect of the polymorphism was also seen in hospital-based studies in allmodels (GT/TT: OR = 0.74, 95%CI = 0.57-0.97; GG/TT: OR = 0.55, 95%CI = 0.38-0.79; dominant model: OR= 0.69, 95%CI = 0.54-0.89; recessive model: OR = 0.70, 95%CI = 0.51-0.97). However, more primary studieswith a larger number of samples are required to confirm our findings.http://journal.waocp.org/article_26848_10c5217a9211c882e9a3d9a5e9a0f722.pdf2012-09-01T11:23:202017-12-14T11:23:2043274330MDM2Polymorphismprostate cancer riskMeta-analysisORIGINAL_ARTICLEMarkers of Bone Metastases in Breast and Lung CancersAim and Background: The aim of the present study was to evaluate correlations between serum osteocalcin,osteoprotegerin and NTX (Cross-linked N-telopeptides of Type I Collagen) and urinary NTX in breast andlung cancer patients with bone metastases. These four markers are considered to have important roles in boneformation, resorption and metastases. Methods: Four markers were determined in the sera of 60 breast cancerand 21 lung cancer patients and healthy controls (n=30). Serum levels were studied using ELISA and EIA.Results: The median levels of serum osteoprotegerin (p<0.001) and osteocalcin (p=0.003) were higher in patients.Significant correlations were observed between the serum NTX-osteocalcin (r=0.431; p<0.001), serum NTXosteoprotegerin(r=0.42; p=0.003) and serum NTX - urine NTX (r=0.255; p=0.022). Conclusion: We concludethat osteocalcin, osteoprotegerin and NTX are independent diagnostic tools. Due to the ease of urine collection,urine NTX may be applied routinely to allow early detection of bone metastases and indicate progression of thedisease.http://journal.waocp.org/article_26849_1a6941adafe6601d6bb570dddf621a4c.pdf2012-09-01T11:23:202017-12-14T11:23:2043314334Bone metastasescancertumor markerORIGINAL_ARTICLESirolimus and Non-melanoma Skin Cancer Prevention after Kidney Transplantation: A Meta-analysisBackground: Whether sirolimus is useful in the prevention of non-melanoma skin cancer (NMSC) remainsunclear and we therefore performed this meta-analysis of randomized controlled trials to test the hypothesis thatSirolimus-based immunosuppression is associated with a decrease in NMSC. Methods: The main outcomes wereNMSC, squamous-cell carcinoma and basal-cell carcinoma. The pooled risk ratio (RR) with its 95% confidenceinterval (95%CI) were used to assess the effects. Results: 5 randomized trials involving a total of 1499 patientsreceiving kidney transplantation were included. Patients undergoing Sirolimus-based immunosuppression hadmuch lower risk of NMSC (RR = 0.49, 95%CI 0.32-0.76, P = 0.001). Subgroup analyses by tumor type showedthat Sirolimus-based immunosuppression significantly decreased risk of both squamous-cell carcinoma (RR= 0.58, 95%CI 0.43-0.78, P < 0.001) and basal-cell carcinoma (RR = 0.56, 95%CI 0.37-0.85, P = 0.006). Thequality of evidence was high for NMSC, and moderate for squamous-cell carcinoma and basal-cell carcinoma.No evidence of publication bias was observed. Conclusion: High quality evidence suggests that Sirolimus-basedimmunosuppression decreases risk of non-melanoma skin cancer, and Sirolimus has an antitumoral effect amongkidney-transplant recipients.http://journal.waocp.org/article_26850_2794c3d323fa3879488fb8cbe068c200.pdf2012-09-01T11:23:202017-12-14T11:23:2043354339Sirolimusnon-melanoma skin cancerKidney TransplantationMeta-analysisORIGINAL_ARTICLEReduced Expression of Limd1 in Ulcerative Oral Epithelium Associated with Tobacco and Areca NutPurpose: The aim of this study was to cast light on initiating molecular events associated with the developmentof premalignant oral lesions induced by tobacco and/or areca nut. Method: Immunohistochemical analyses ofcell cycle regulatory proteins (LIMD1, RBSP3, p16, RB, phosphorylated RB, p53), EGFR and SH3GL2 (EGFRassociated protein) were performed with inflammatory/ ulcerative epithelium and adjacent hyperplastic/milddysplastic lesions. Results: No change in expression of the proteins was seen in inflammatory epithelium. Reducednuclear expression of LIMD1 was evident in ulcerative epithelium. In hyperplastic lesions, reduced expression ofRBSP3, p16, SH3GL2 and overexpression of p-RB and EGFR were apparent. Reduced nuclear expression of p53was observed in mild dysplastic lesions. Conclusion: Our data suggest that inactivation of LIMD1 in ulcerativeepithelium might predispose the tissues to alterations of other cell cycle regulatory and EGFR signaling proteinsneeded for the development of premalignant oral lesions.http://journal.waocp.org/article_26851_35a3880d7831666743e4a385e917dbf4.pdf2012-09-01T11:23:202017-12-14T11:23:2043414346EGFRLIMD1premalignant oral lesionsRBRBSP3SH3GL2ORIGINAL_ARTICLETrends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, YemenBackground: Breast cancer is the most common cancer of women and the principal cause of death in middleaged women. The objective of this study was to describe the trend of breast cancer and its management in Adenand adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is aretrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-easterngovernorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time andtype of presentation, disease stage, pathological types and the performed surgical treatment. The sources ofinformation were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; majorreferral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total numberof patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years(60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signsof advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer(stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was thecommonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy(50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanceddisease. Improving health awareness and earlier diagnosis of the disease by health education, encouragingbreast self-examination, and providing the mammography equipment and mammary clinics in hospitals arerecommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.http://journal.waocp.org/article_26852_428532129fb42cfa1b03d48645b083c8.pdf2012-09-01T11:23:202017-12-14T11:23:2043474351Breast canceradvanced breast diseaseclinical patternsmastectomyYemenORIGINAL_ARTICLENon-enzymatic Antioxidant Status and Biochemical Parameters in the Consumers of Pan Masala Containing TobaccoBackground: Tobacco consumption is one of the leading causes of oral submucous fibrosis, oral cancerand even premature death. The present study was designed to compare the biochemical parameters and nonenzymaticantioxidant status and the lipid peroxidation products in pan masala tobacco users as compared withage-matched non-user controls. Methods: Pan masala and tobacco users of age 33.2±9.94 years and age-matchedcontrols (31.2±4.73 years) were enrolled for the study. Plasma levels of vitamin E, vitamin C, albumin, bilirubin,uric acid, glucose, urea, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT) weremeasured by standard methods. Serum malondialdehyde (MDA) levels were estimated as a measure of lipidperoxidation. Results: In the pan masala tobacco users, as compared to the controls, the level of vitamin C(68.5±5.9 vs 97.9±9.03 μmol/L, p≤0.05) vitamin E (18.4±5.3 vs 97.9±9.03 μmol/L, p≤0.001), albumin (37.5±7.01vs 44.3±9.99 g/L, p≤0.001), and malondialdehyde (10.8±1.29 vs 1.72±1.15 nmol/ml, p≤0.001 ) were found to besignificantly altered. Malondialdehyde was significantly correlated with vitamin E (r=1.00, p<0.001) and vitaminC (r =1.00, p<0.001) in pan masala tobacco users. Serum levels of AST (31.0±16.77 IU) and ALT (36.7±31.3 IU) inthe pan masala tobacco users were significantly raised as compared to the controls (AST, 25.2±9.51 IU, p=0.038;ALT, 26.2±17.9 IU, p=0.038). Conclusion: These findings suggest that pan masala tobacco users are in a stateof oxidative stress promoting cellular damage. Non-enzymatic antioxidants are depleted in pan masala tobaccousers with subsequent alteration in the biochemical parameters. Supplementation of antioxidants may preventoxidative damage in pan masala tobacco users.http://journal.waocp.org/article_26853_68c0ab7f500296efb756d6b20eb87dda.pdf2012-09-01T11:23:202017-12-14T11:23:2043534356Pan masala tobaccoAntioxidantsNepalORIGINAL_ARTICLEAre there Time-period-related Differences in the Prophylactic Effects of Bacille Calmette-Guérin Intravesical Instillation Therapy in Japan?Objective: The guidelines on indications for prophylactic use of Bacille Calmette-Guérin (BCG) against nonmuscle-invasive bladder cancer (NMIBC) have changed over the years. In order to assess the impact on outcome,the present retrospective comparison of BCG efficacy by time period with Japanese patients was conducted.Patients and Methods: A total of 146 cases of NMIBC treated with BCG since February 1985 were retrospectivelyevaluated. All patients received 80 mg of BCG (Tokyo 172 strain) six to eight times a week for prophylactic use.Comparison was made among three historical groups (Group A: 1980’s, 39 cases; Group B: 1990’s, 61 cases;Group C: 2000’s, 46 cases). Results: In total, recurrence was seen in 55 of the 146 cases (37.7%), and progressionin 14 (9.6%), 1 patient dying of cancer. These overall results were similar to those outlined in previous reports.However, the outcomes of this time-period-based analysis indicated a tendency for a shorter time to recurrencein patients after 2000, although a log-rank test showed no significance (P=0.229). Seven of the cases featuringprogression (i.e., half of all such cases) were among the 46 Group C patients (15.2%). Excluding these progressivecases, there was no significant difference among the remaining 132 patients in the three groups. Conclusion:This study results revealed a tendency for a lower non-recurrence rate after 2000 in our series. This could stemfrom a number of factors, including changes in BCG indication criteria and the evolution of histopathologicaldiagnostic criteria.http://journal.waocp.org/article_26854_928c621f3280cdfc9f9445b5560733c5.pdf2012-09-01T11:23:202017-12-14T11:23:2043574361Bacille Calmette-Gu&eacuterin - non-muscle-invasive bladder cancer - time period - Japanese patientsORIGINAL_ARTICLEUp-regulation of NICE-3 as a Novel EDC Gene Could Contribute to Human Hepatocellular CarcinomaThe epidermal differentiation complex (EDC) contains a large number of gene products which are crucialfor the maturation of the human epidermis and can contribute to skin diseases, even carcinogenesis. It isgenerally accepted that activation of oncogenes and/or inactivation of tumor suppressor genes play pivotalroles in the process of carcinogenesis. Here, NICE-3, a novel EDC gene, was found to be up-regulated in humanhepatocellular carcinoma (HCC) by quantitative real-time RT-PCR. Furthermore, overexpression of exogenousNICE-3 by recombinant plasmids could significantly promote cell proliferation, colony formation and soft agarcolony formation in Focus and WRL-68 HCC cell lines. Reversely, NICE-3 silencing by RNA interference couldmarkedly inhibit these malignant phenotypes in YY-8103 and MHCC-97H cells. Moreover, cell cycle analysis ofMHCC-97H transfected with siRNA by flow cytometry showed that NICE-3 knockdown may inhibit cell growthvia arrest in G0/G1 phase and hindering entry of cells into S phase. All data of our findings indicate that NICE-3may contribute to human hepatocellular carcinoma by promoting cell proliferation.http://journal.waocp.org/article_26855_7c0ecc4e8f09aff04e25878fea21dce6.pdf2012-09-01T11:23:202017-12-14T11:23:2043634368Hepatocellular carcinomaNICE-3C1orf43NS5ATP4EDCCell proliferationORIGINAL_ARTICLEMetastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in PakistanAim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictorof prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease.In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer carecenter of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials& Methods: All cases of bony metastatic disease were included that presented in the Pathology Department ,from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas,sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results:A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were maleand 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, withfemur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate andgastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sitesof metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to considerin the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data arecomparable with international findings and the literature available regarding the site and distribution of skeletalmetastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primariesin females and gastrointestinal tract cancers in males in our study.http://journal.waocp.org/article_26856_91785d73b41e82966936217acf58cc26.pdf2012-09-01T11:23:202017-12-14T11:23:2043694371Bonemetastatic tumorcancerPakistanORIGINAL_ARTICLEImpact of Chemotherapy on Hypercalcemia in Breast and Lung Cancer PatientsIntroduction: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokinesincluding parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occurin patients with or without bone metastases. The present study aimed to describe the effect of chemotherapytreatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia.Methods: We carried a review of medical records of breast and lung cancer patients hospitalized in years2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia.Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis orduring cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapytypes and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levelsat first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latestchemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data,logistic regression test for categorical variables, and Spearman correlation test, linear regression and the pairedsample t tests for continuous data. Results: Of a total 1,023 of breast cancer and 814 lung cancer patientsidentified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lungcancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia(10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl).Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia;in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, andgemcitabine+cisplatin in lung cancer. Conclusion: Chemotherapy decreases calcium levels in breast and lungcancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.http://journal.waocp.org/article_26857_571bf023c18c8689bd2e84e74d616ed0.pdf2012-09-01T11:23:202017-12-14T11:23:2043734378HypercalcemiaPTHrPchemotherapy typeBreast cancerLung cancerORIGINAL_ARTICLEComparison Different Methods of Intraoperative and Intraperitoneal Chemotherapy for Patients with Gastric Cancer: A Meta-analysisPurpose: To investigate the efficacy and safety of intraperitoneal chemotherapy (IPC) for patients withgastric cancer and to compare effects between different regimens of IPC. Method: Randomized controlledtrials comparing the effects of surgery plus intraperitoneal chemotherapy with surgery alone or comparing theefficacy between different regimens of intraperitoneal chemotherapy were searched for in Medline, Embase,Pubmed, the Cochrane Library and the Chinese BioMedical Disc and so on by two independent reviewers.After quality assessment and data extraction, data were pooled for meta-analysis using RevMan5.16 software.Tests of interaction were used to test for differences of effects among subgroups grouped according to differentIPC regimens. Results: Fifteen RCTs with a total of 1713 patients with gastric cancer were included for qualityassessment and data extraction. Ten studies were judged to be of fair quality and entered into meta-analysis.Hyperthermic intraoperative intraperitoneal chemotherapy (HR=0.60, P<0.01), hyperthermic intraoperativeintraperitoneal chemotherapy plus postoperative intraperitoneal chemotherapy (HR=0.47, P<0.01) andnormothermic intraoperative intraperitoneal chemotherapy (HR=0.70, P=0.01) were associated with a significantimprovement in overall survival. Tests of interaction showed that hyperthermia and additional postoperativeintraperitoneal chemotherapy did not impact on its effect. Further analysis revealed that intraperitonealchemotherapy remarkably decrease the rate of postoperative hepatic metastasis by 73% (OR=0.27, 95% CI=0.12to 0.67, P<0.01). However, intraperitoneal chemotherapy increased risks of marrow depression (OR=5.74,P<0.01), fever (OR=3.67, P=0.02) and intra-abdominal abscess (OR=3.57, P<0.01). Conclusion: The presentmeta-analysis demonstrates that hyperthermic intraoperative intraperitoneal chemotherapy and normothermicintraoperative intraperitoneal chemotherapy should be recommended to treat patients with gastric cancerbecause of improvement in overall survival. However, it is noteworthy that intraperitoneal chemotherapy canincrease the risks of marrow depression, intra-abdominal abscesses, and fever.http://journal.waocp.org/article_26858_4451890bff3fcbed7f2f24b3f0deb915.pdf2012-09-01T11:23:202017-12-14T11:23:2043794385Gastric cancerintraperitoneal chemotherapyMeta-analysishepatic metastasisOverall survivalsafetyORIGINAL_ARTICLESurvival of Patients with Lung Cancer, Yazd, IranBackground: Lung carcinoma is the leading cause of cancer mortality worldwide. Although the 5-year survivalrate nearly tripled from 5-15% over the last 25 years, the estimated number of deaths still exceeds 1.3 millionannually. The overall 5-year survival of lung cancer is only 10% in Europe and 15% in the United States. Theaim of the current study was to determine the long-term survival and the effect of certain prognostic factorson survival of patients with lung cancer in Yazd city, Iran. Methods: In this cross-sectional descriptive study,we retrospectively reviewed hospital records and follow-up data of 148 patients with histological proven lungcancer using the cancer data registered between 1998 and 2005 in the pathology department of Shahid Sadoughieducational hospital, Yazd, Iran. Data were extracted from patient documents that included sex, age, clinicalmanifestations, histopathological report of the tumor and type of treatment given. Results: Overall survivaltime in all patients was 8.5 months after diagnosis and there was no significant difference in survival accordingto sex (p=0.958). Histological analysis revealed that squamous cell carcinoma was the most common histologictype (35%). Kaplan-Meier statistical methods estimated the average survival time for SCC to be better (22.6months) in comparison with the other types of histology (all of them below 10 months). There was a trend towardssignificance between type of histology and duration of survival (p=0.08). Conclusion: It is reasonable to expectthat early lung cancer detection, and appropriated treatment, may improve surgical morbidity and mortality.Low survival of lung cancer in our center patients show our shortages in screening programs for early diagnosis.Designing studies with larger sample size that take some other variables like staging of patients is now necessary.http://journal.waocp.org/article_26859_fdb1d20e74d52c137f4a5c9c245c7a10.pdf2012-09-01T11:23:202017-12-14T11:23:2043874391CarcinomaLungprognosisSurvivalIranORIGINAL_ARTICLEAmelioration of 1,2 Dimethylhydrazine (DMH) Induced Colon Oxidative Stress, Inflammation and Tumor Promotion Response by Tannic Acid in Wistar RatsColon cancer is the third most common malignant neoplasm in the world and it remains an important causeof death, especially in western countries. The toxic environmental pollutant, 1, 2-dimethylhydrazine (DMH), isalso a colon-specific carcinogen. Tannic acid (TA) is reported to be effective against various types of chemicallyinduced toxicity and also carcinogenesis. In the present study, we evaluated the chemopreventive efficacy of TAagainst DMH induced colon toxicity in a rat model. Efficacy of TA against the colon toxicity was evaluated interms of biochemical estimation of antioxidant enzyme activities, lipid peroxidation, histopathological changesand expression of early molecular markers of inflammation and tumor promotion. DMH treatment inducedoxidative stress enzymes (p<0.001) and an early inflammatory and tumor promotion response in the colons ofWistar rats. TA treatment prevented deteriorative effects induced by DMH through a protective mechanismthat involved reduction of oxidative stress as well as COX-2, i-NOS, PCNA protein expression levels and TNF-α(p<0.001) release. It could be concluded from our results that TA markedly protects against chemically inducedcolon toxicity and acts plausibly by virtue of its antioxidant, anti-inflammatory and antiproliferative activities.http://journal.waocp.org/article_26860_76151a3656d3a07a764e80666ea01b94.pdf2012-09-01T11:23:202017-12-14T11:23:2043934402DMHinflammationOxidative stresstumor promotion and tannic acidORIGINAL_ARTICLEGlutathione-S-Transferase T1 Polymorphism is Associated with Esophageal Cancer Risk in Chinese Han PopulationBackground: Glutathione-S-Transferase T1 (GSTT1) gene has been shown to be involved in the developmentof esophageal cancer. However, the results have been inconsistent. In this study, the authors performed a metaanalysisto clarify the association between GSTT1 polymorphism and esophageal cancer risk among ChineseHan population. Methods: Published literature from PubMed, the China National Knowledge Infrastructureand Wanfang Data were searched. Pooled odds ratio (OR) and 95% confidence interval (95%CI) was calculatedusing a fixed- or random-effects model. Results: Eleven studies with a total of 2779 individuals were included inthe meta-analysis. The results showed that GSTT1 null genotype was significantly associated with esophagealcancer risk in Chinese (OR = 1.31, 95%CI 1.12 to 1.53, p = 0.001). Further sensitivity analyses confirmed thesignificant association. The cumulative meta-analysis showed a trend of an obvious association between GSTT1null genotype and esophageal cancer risk as information accumulated by year. Conclusions: This meta-analysissuggests a significant association of GSTT1 null genotype with esophageal cancer risk in the Chinese Hanpopulation.http://journal.waocp.org/article_26861_801e4d385589c477dd9560f4142917cd.pdf2012-09-01T11:23:202017-12-14T11:23:2044034407Glutathione-S-transferase T1Esophageal cancerMeta-analysisChineseORIGINAL_ARTICLEEstimation of Superoxide Dismutase and Glutathione Peroxidase in Oral Submucous Fibrosis, Oral Leukoplakia and Oral Cancer - A Comparative StudyPresent study was undertaken to estimate and compare erythrocyte superoxide dismutase (E-SOD) andGlutathione peroxidase (GPx) levels in oral submucous fibrosis, oral leukoplakia and oral cancer patients andage/sex matched healthy subjects, 25 in each group. Statistically significant (P<0.001) decrease in E-SOD andGPx levels were observed in OSF, oral leukoplakia and oral cancer groups as compared to the control group.Oral leukoplakia group showed lower levels in comparison with OSF (P>0.05). Oral cancer group had the lowestlevels amongst the study groups. Imbalance in antioxidant enzyme status may be considered as one of the factorsresponsible for the pathogenesis of cancer and may serve as a potential biomarker and therapeutic target toreduce the malignant transformation in oral premalignant lesions/conditions.http://journal.waocp.org/article_26862_02eed077dd9d90e81e65bf087e4f010e.pdf2012-09-01T11:23:202017-12-14T11:23:2044094412Oral submucous fibrosisOral leukoplakiaOral cancerSuperoxide dismutaseglutathione peroxidaseORIGINAL_ARTICLEPrognostic Significance of GSTP1, XRCC1 and XRCC3 Polymorphisms in Non-small Cell Lung Cancer PatientsAim: Individual differences in chemosensitivity and clinical outcome in non-small cell lung cancer (NSCLC)patients treatment with platinum-based chemotherapy may be due to genetic factors. Our study aimed toinvestigate the prognostic role of GSTP1, XRCC1 and XRCC3 in NSCLC patients treated with chemotherapy.Methods: A total of 460 cases were consecutively selected from The Affiliated Hospital of Nantong Universitybetween Jan. 2003 to Nov. 2006, and all were followed-up until Nov. 2011. Genotyping of GSTP1 Ile105Val, XRCC1Arg194Trp, XRCC1 Arg399Gln and XRCC3 Thr241Met was conducted by duplex polymerase-chain-reactionwith confronting-two-pair primer methods. Results: Patients with GSTP Val/Val exhibited a shorter survivaltime, and had a 1.89 fold greater risk of death than did those with the IIe/IIe genotype. For XRCC1 Arg194Trp,the variant genotype Trp/Trp was significantly associated with a decreased risk of death from NSCLC whencompared with the Arg/Arg. Individuals carrying XRCC1 399Gln/Gln genotype had a longer survival time,with a lowered risk of death from NSCLC. Conclusion: This study indicated that GSTP1 Ile105Val, XRCC1Arg194Trp and XRCC1Arg399Gln genes have a role in modifying the effect of platinum-based chemotherapyfor NSCLC patients in a Chinese population. Our findings provide information for therapeutic decisions forindividualized therapy in NSCLC cases.http://journal.waocp.org/article_26863_76923bc835b3229aef51ddb0ebeaa910.pdf2012-09-01T11:23:202017-12-14T11:23:2044134416GST-piXRCC1XRCC3non-small cell lung cancerprognosisChemotherapyORIGINAL_ARTICLERelationship Between GSTT1 Gene Polymorphism and Hepatocellular Carcinoma in Patients from ChinaObjective: The results from studies on associations of the glutathione S-transferase T1 (GSTT1) genepolymorphism and hepatocellular carcinoma (HCC) risk in Chinese populations are still conflicting. This metaanalysiswas performed to evaluate the relationship in detail. Methods: Eligible reports were recruited into thismeta-analysis from the databases of PubMed, Embase, Cochrane Library and CBM-disc (China BiologicalMedicine Database). Results were expressed with odds ratios (OR) for dichotomous data, and 95% confidenceintervals (CI) were also calculated. Results: Eighteen investigations were identified for the analysis of associationbetween polymorphic deletion of GSTT1 and HCC, consisting of 2,693 patients with HCC and 4,696 controls.Null genotype of GSTT1 was associated with HCC susceptibility in Chinese (OR=1.53, 95%CI: 1.28-1.82;P﹤0.00001). Conclusion: The GSTT1 null genotype is associated with HCC susceptibility in Chinese.http://journal.waocp.org/article_26864_4cbf7e36e77a6721f6d20989b9ca463e.pdf2012-09-01T11:23:202017-12-14T11:23:2044174421Hepatocellular carcinomaglutathione S-transferase T1Gene PolymorphismMeta-analysisORIGINAL_ARTICLEAssociation of XPD and XRCC1 Genetic Polymorphisms with Hepatocellular Carcinoma RiskAim: XRCC1 and XPD are two major repair genes involved in nucleotide excision repair (NER), whichis reported to be associated with risk of several cancers. We explored the association of XRCC1 and XPDpolymorphisms with the risk of HCC. Methods: A total of 410 cases with HCC and 410 health controls werecollected. XRCC1 Arg194Trp, XRCC1 Arg399Gln, XPD Lys751Gln and XPD Asp312Asn genotyping wasperformed by duplex polymerase-chain-reaction with the confronting-two-pair primer (PCR-CTPP) method.Results: XRCC1 194Trp/Trp was strongly significantly associated with an increased risk of HCC cancer whencompared with the wide-type genotype (OR=2.26, 95% CI=(1.23-5.38). Individuals carrying the XRCC1 399Gln/Gln showed increased risk of HCC (OR=1.74, 95%CI=1.06-2.74). The XPD 751Gln/Gln and Gln allele genotypewere associated with strong elevated susceptibility to HCC (OR=3.51 and 1.42, respectively). Conclusion: Theseresults suggest that polymorphisms in XRCC1 and XPD may have functional significance in risk of HCC.http://journal.waocp.org/article_26865_1031d4ed3e6e8922af85ffa8f895ce2e.pdf2012-09-01T11:23:202017-12-14T11:23:2044234426XRCC1XPDHepatocellular carcinomaSusceptibilityORIGINAL_ARTICLEKnowledge, Perception, Practice and Barriers of Breast Cancer Health Promotion Activities among Community Pharmacists in Two Districts of Selangor State, MalaysiaBreast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia.Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancerscreening rates are still low in the country. The community pharmacist, as one of the most accessible healthcarepractitioners, could play a role in the provision of breast cancer health promotion services to the community.However, there are no documented data regarding the community pharmacists’ involvement in breast cancerrelated health promotion activities. Hence, this study was conducted to examine self-reported knowledge,practice and perception of community pharmacists on provision of breast cancer health promotion servicesand to investigate the barriers that limit their involvement. This cross-sectional survey conducted between Mayto September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langatand Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scalequestions was used to interview those pharmacists who gave their informed consent to participate in the study.The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on theknowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breastcancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancerhealth promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lackof training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the communitypharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there isneed to equip community pharmacists with necessary training and knowledge to enable them to contribute theirshare towards prevention and screening of breast cancer.http://journal.waocp.org/article_26866_a32b6739747ee162a772e84dc67a0605.pdf2012-09-01T11:23:202017-12-14T11:23:2044274430Breast cancercommunity pharmacistsHealth promotionMalaysiaORIGINAL_ARTICLENature of Lesions Undergoing Radical Nephrectomy for Renal CancerAim: The aim of the present study was to evaluate retrospectively histopathologically-diagnosed lesionsthat were detected in the kidney after radical nephrectomy for a preoperative diagnosis of kidney cancer.Methods: The medical records of 83 patients (51 male, 32 female) were included. Preoperative staging wasaccomplished by various methods including physical examination, blood hemography and biochemistry,abdominal ultrasonography (US), chest x-ray, abdominal computed tomography (CT) and abdominal magneticresonance imaging (MRI). Results: Totals of 70 patients underwent radical nephrectomy and 13 nephronsparing surgery. Of the 83 patients, 70 had malignant lesions (renal cell carcinoma, squamous cell carcinomaor other malignancies) 13 had a variety of benign lesions, the most frequently detected being oncoytoma (6),angiomyolipoma (3), xanthogranulamatous pyelonephritis (2), cortical cyst (1) and chronic pyelonephriticchange (1). Conclusion: It was concluded that in spite of great technological developments regarding radiologicalimaging modalities such as US, CT and MRI, benign lesions might still be detected pathologically in patientswho undergo radical nephrectomy with the preoperative diagnosis of renal cancer. But, all renal masses shouldbe regarded as malignant and should be managed surgically otherwise proven benign.http://journal.waocp.org/article_26867_6084b81a62101eba63b8f8028fdfac0f.pdf2012-09-01T11:23:202017-12-14T11:23:2044314433Kidney tumorsrenal cell carcinomahistopathologybenign lesionsORIGINAL_ARTICLESilencing of Twist Expression by RNA Interference Suppresses Epithelial-mesenchymal Transition, Invasion, and Metastasis of Ovarian CancerPurpose: This study aimed to explore the role of the Twist gene in the epithelial-mesenchymal transition ofovarian cancer. Methods: An RNA interference plasmid expressing a small interfering RNA (siRNA)-targetingTwist (Twist siRNA vector) was designed, constructed, and transfected into the human ovarian cancer cell lineA2780. Transfection efficiency was assessed under a fluorescence microscope. Changes in the expression of TwistmRNA in A2780 after transfection with the pGenesil Twist shRNA plasmid were analyzed through RT-PCR.MTT assays and adhesion experiments were applied to determine changes in proliferation and adhesion abilityof A2870 after transfection with the Twist shRNA plasmid. Changes in the expression of the E-cadherin andN-cadherin proteins in A2780 after transfection with the Twist shRNA plasmid were analyzed using Westernblotting. Result: The restructuring plasmid pGenesil-Twist shRNA was constructed successfully. After 48 h ofculture, 80% of the cells expressed high-intensity GFP fluorescence and stability. The expression of Twist decreasedsignificantly after the transfection of the Twist shRNA plasmid (P<0.05). Proliferation of the transfected TwistshRNA cells showed no difference with that of the A2780-nontransfection or A2780-si-control groups (P>0.05) butthe adhesion ability of A2780 decreased dramatically (P<0.05). Expression of the E-cadherin protein increased,whereas that of the N-cadherin protein decreased compared with that in the A2780-nontransfection or A2780-si-control groups (P<0.05). Conclusion: Twist is essential for epithelial-mesenchymal transition, invasion, andmetastasis of ovarian cancer.http://journal.waocp.org/article_26868_ae6cbda5c681590a1a658b4519c0e989.pdf2012-09-01T11:23:202017-12-14T11:23:2044354439TwistRNAiovarian cancerepithelial methenchymal transitionORIGINAL_ARTICLEMeta-analysis of the Relation Between the VDR Gene TaqⅠpolymorphism and Genetic Susceptibility to Prostate Cancer in Asian PopulationsBackground: Polymorphisms of the Taq I gene have been associated with prostate cancer risk. Methods:Weapplied a fixed-effects model to combine odds ratios (ORs) and 95% confidence intervals (95% CI). The Egger’stest was carried out to evaluate potential publication bias. Results: A total of 10 case-control studies enrolling1,141 prostate cancer patients and 1,685 controls were included in this meta-analysis. Compared with the Tallele, the OR for the C allele was 0.81 (0.70-0.94). The ORs for CT and CC+CT genotypes were 0.86 (0.74-1.01)and 0.84 (0.73-0.97) compared to wide type genotype (homozygote TT). Conclusions: The present meta-analysissuggests that the TF gene Taq I polymorphism may reduce the prostate cancer risk in Asian populations.http://journal.waocp.org/article_26869_ec67e14dc2089917a2b5897c62a04f93.pdf2012-09-01T11:23:202017-12-14T11:23:2044414444Vitamin D receptorTaq IProstate CancerAsian populationsMeta-analysisORIGINAL_ARTICLECharacteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor AngiogenesisBackground: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis.This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus onthe relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological datawere retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductalcarcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantifiedas microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study wereadvanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positivelymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesteronereceptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triplenegative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density wasobserved in the younger patient age group (p=0.012). There were no significant associations between microvesseldensity and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of thisinstitution had advanced stage disease with poorer prognostic factors as compared to other local and westernstudies. Breast cancer in younger patients might be more proangiogenic.http://journal.waocp.org/article_26870_a3b3f0b2ac1ddae090f7cc2ae52789f6.pdf2012-09-01T11:23:202017-12-14T11:23:2044454452Breast cancerinvasive ductal carcinomatumor angiogenesismicrovessel densityORIGINAL_ARTICLETanshinone II-A Inhibits Angiogenesis through Down Regulation of COX-2 in Human Colorectal CancerAngiogenesis plays a significant role in colorectal cancer (CRC) and cyclooxygenase-2 (COX-2) appears tobe involved with multiple aspects of CRC angiogenesis. Our aim was to investigate the inhibitory effects of TanII-A (Tanshinone II-A, Tan II-A) on tumor growth in mice, as well as alteration of expression of COX-2 andVEGF in CRC. We established the mice xenograft model of C26 CRC cell line, and injected 0.5, 1, 2mg/kg ofTan II-A and 1mg/kg of 5-FU in respectively in vivo. Then, we assayed tumor weight and volume, and evaluatedmicrovascular density and expression of VEGF. COX-2 promoter and COX-2 plasmids were transfected intoHCT-116 cells, followed by detection of COX-2 promoter activity by chemiluminescence, and detection of COX-2mRNA expression by fluorescence quantitative PCR. Taken together, the results showed Tan II-A could inhibittumor growth and suppress the VEGF level in vivo. HCT-116 cell experiments showed marked inhibitory effectsof Tan II-A on COX-2 and VEGF in a dose-dependent manner. The results indicate that Tan II-A can effectivelyinhibit tumor growth and angiogenesis of human colorectal cancer via inhibiting the expression level of COX-2and VEGF.http://journal.waocp.org/article_26871_913c6257681c99440db9a0f4cc563fb0.pdf2012-09-01T11:23:202017-12-14T11:23:2044534458Tanshinone II-AColorectal carcinomaAngiogenesiscyclooxygenase 2Vascular Endothelial Growth FactorORIGINAL_ARTICLEDo Saudi Nurses in Primary Health Care Centres have Breast Cancer Knowledge to Promote Breast Cancer Awareness?Background: Breast cancer is one of the leading causes of death among cancer patients in Saudi Arabia. It isknown that nurses play a key role in promoting breast cancer awareness among women in any society. Nursesin primary health care centres (PHCC) have more direct contact with general population. This study aimed toinvestigate nurse knowledge of breast cancer and practice of early screening in PHCC in Jeddah city. Methods:A cross-sectional study was conducted using a self-administered questionnaire to assess the general knowledge ofbreast cancer, risk factors, and practice of 210 PHCC nurses. Data were analysed using SPSS v.16. Results: Themean age of the PHCC Nurses was 36.9 (SD ±8.6). Only 11% percent scored <50% of the total score for generalepidemiological knowledge on breast cancer, about 35% scored <50% of the total score for breast cancer riskfactors. Sixty seven percent scored >75% of the total score on breast cancer signs. Majority of nurses 62.8%practiced BSE, but only 4% practiced regularly every month. Some 28% practiced once per year. About 81%of the nurses had not had a clinical breast examination and only 14% had had a mammography. The results ofthe study failed to show any correlation between the knowledge scores with age, education, year of experience,family history of BC and marital status of the nurses. Conclusion:The results from the study reflect that thereis a need to provide continuing nursing education programmes for PHCC nurses to improve their breast cancerknowledge and practice.http://journal.waocp.org/article_26872_4190f4a8b5faa0899e699f4a556cbd10.pdf2012-09-01T11:23:202017-12-14T11:23:2044594464Saudi nursesBreast cancerawarenessprimary health care centreBreast Cancer ScreeningORIGINAL_ARTICLELack of Association of Glutathione S-transferase M3 Gene Polymorphism with the Susceptibility of Lung CancerObjective: The conclusions of published reports on the relationship between the glutathione S-transferaseM3 (GSTM3) A/B gene polymorphism and the risk of lung cancer are still debated. This meta-analysis wasperformed to evaluate the association between GSTM3 and the risk of lung cancer. Methods: Associationinvestigations were identified from PubMed, Embase, and Cochrane Library, and eligible studies were includedand synthesized using a meta-analysis method. Results: Eight reports were included into this meta-analysis forthe association of GSTM3 A/B gene polymorphism and lung cancer susceptibility, covering 1,854 patients withlung cancer and 1,926 controls. No association between the GSTM3 A/B gene polymorphism and lung cancerwas found in this meta-analysis (B allele: OR = 1.25, 95% CI: 0.89-1.76, P = 0.20; BB genotype: OR = 1.53, 95%CI: 0.71-3.32, P = 0.28; AA genotype: OR = 0.85, 95% CI: 0.59-1.23, P = 0.39). Conclusions: The GSTM3 A/Bgene polymorphism is not associated with lung cancer susceptibility. However, more studies on the relationshipbetween GSTM3 A/B gene polymorphism and the risk of lung cancer should be performed in the future.http://journal.waocp.org/article_26873_35c906e128fc5176fe7da8b9904e66dc.pdf2012-09-01T11:23:202017-12-14T11:23:2044654468Lung cancerglutathione S-transferase M3A/B gene polymorphismMeta-analysisORIGINAL_ARTICLELINE-1 and Alu Methylation Patterns in Lymph Node Metastases of Head and Neck CancersBackground: The potential use of hypomethylation of Long INterspersed Element 1 (LINE-1) and Alu elements(Alu) as a biomarker has been comprehensively assessed in several cancers, including head and neck squamouscell carcinoma (HNSCC). Failure to detect occult metastatic head and neck tumors on radical neck lymph nodedissection can affect the therapeutic measures taken. Objective: The aim of this study was to investigate theLINE-1 and Alu methylation status and determine whether it can be applied for detection of occult metastatictumors in HNSCC cases. Methods: We used the Combine Bisulfite Restriction Analysis (COBRA) techniqueto analyse LINE-1 and Alu methylation status. In addition to the methylation level, LINE-1 and Alu loci wereclassified based on the methylation statuses of two CpG dinucleotides in each allele as follows: hypermethylation(mCmC), hypomethylation (uCuC), and 2 forms of partial methylation (mCuC and uCmC). Sixty-one lymph nodeswere divided into 3 groups: 1) non-metastatic head and neck cancer (NM), 2) histologically negative for tumor cellsof cases with metastatic head and neck cancer (LN), and 3) histologically positive for tumor cells (LP). Results:Alu methylation change was not significant. However, LINE-1 methylation of both LN and LP was altered, asdemonstrated by the lower LINE-1 methylation levels (p<0.001), higher percentage of mCuC (p<0.01), lowerpercentage of uCmC (p<0.001) and higher percentage of uCuC (p<0.001). Using receiver operating characteristic(ROC) curve analysis, %uCmC and %mCuC values revealed a high level of AUC at 0.806 and 0.716, respectively,in distinguishing LN from NM. Conclusion: The LINE-1 methylation changes in LN have the same pattern asthat in LP. This epigenomic change may be due to the presence of occult metastatic tumor in LN cases.http://journal.waocp.org/article_26874_51276adc786259cb30161276131fdbc1.pdf2012-09-01T11:23:202017-12-14T11:23:2044694475Long INterspersed element-1s (LINE-1s)Alu elementsDNA methylationlymph nodesoccult tumorORIGINAL_ARTICLEAbsence of P53 Gene Mutations in Exons 5 - 7 Among Breast Cancer Patients of Bengalee Hindu Caste Females, West Bengal, IndiaBackground: The high incidence and relatively good prognosis of breast cancer has made it the most prevalentcancer in the world today. A large number of distinct mutations and polymorphisms in the p53 gene have beenreported worldwide, but there is no report regarding the role of this inherited susceptibility gene in breast cancerrisk among the Bengalee Hindu Caste females of West Bengal, India. Aim of the Study: We investigated thedistribution and the nature of p53 gene mutations and polymorphisms in exons 5-7 in a cohort of 110 BengaleeHindu breast cancer patients and 127 age, sex and caste matched controls by direct sequencing. Results: We didnot observe any mutations and polymorphisms in our studied individuals. Conclusion: We therefore concludethat mutations in exons 5-7 of p53 gene are rare causes of breast cancer among Bengalee Hindu caste females,and therefore of little help for genetic counseling and diagnostic purposes.http://journal.waocp.org/article_26875_29516178505f6a912a633343822b0836.pdf2012-09-01T11:23:202017-12-14T11:23:2044774479p53 - exons 56 and 7 - Bengalee Hindu caste females - breast cancer - IndiaORIGINAL_ARTICLEAssociation of Chemotherapy-induced Leucopenia with Treatment Outcomes in Advanced Non-small-cell lung Cancer Cases Receiving the NP RegimenBackground: Chemotherapy induced leutropenia has been shown to be associated with improved treatmentoutcomes in selected solid tumors. We studied the association of chemotherapy induced leutropenia with treatmentrelated outcomes in advanced non-small-cell lung cancer. Methods: This is a prospective analysis of patientsreceiving chemotherapy for advanced NSCLC at the Shandong Cancer Hospital from 2005-07.The chemotherapyincluded cisplatin 35 mg/m2, IV on d1,2 and vinorelbine 25 mg/m2 IV on d1,8 every 21 days. Patients were stratifiedinto three groups (A) those experiencing grades 0 leucopenia, group (B) grades 1-2 and group (C) grades 3-4. Theoutcomes studied were response rate (RR), disease control rate (DCR), and time to progression (TTP). Results:128 patients were studied. The RRs in groups A, B and C were 30.8%, 56.8% and 71.4%, respectively, p=0.010.The DCRs were 61.5%, 83.8% and 92.9%, respectively, p=0.009 and the median TTPs were 150 days (95%CI:91-209), 189 days (95%CI: 181-197) and 207 days (95%CI: 172-242), p=0.009. The differences in RR and TTPwere significant. In patients whose CIL kept on 10 days at least, the TTP was significantly prolonged, p=0.0213,and the same was the case for those experiencing grades 1-2 leucopenia and ECOG 0, p=0.0412. Conclusions:Occurrence of CIL correlated with RR and TTP in patients with advanced NSCLC receiving cisplatin andvinorelbine chemotherapy, especially in patients experiencing grades 1-2 leucopenia and ECOG 0, and thesame for those with CIL persisting for 10 days at least. CIL could be a biological measure of drug activity anda marker of efficacy.http://journal.waocp.org/article_26876_9abda526e17d9c89ba1b7a6631c35528.pdf2012-09-01T11:23:202017-12-14T11:23:2044814485ChemotherapyleucopeniaEfficacynon-small-cell lung cancerORIGINAL_ARTICLEAnal Cancer Screening by Modified Liquid-Based Cytology in an HIV ClinicThis study aimed to screen for anal cancer and to determine its cytomorphology using liquid-based cytology(LBC) with specimens preserved in 95% ethyl alcohol. Anal swabs were collected for cytological examinationfrom 177 adult, HIV-infected patients. After collection, sample slides were reviewed and classified accordingto their cytomorphology using the modified Bethesda 2001 system. An abnormal anal Pap smear was found in26.0% of the patients. The diagnoses were: 66.7% negative for intraepithelial lesions (NIL), 14.1% with atypicalsquamous cells of undetermined significance (ASC-US), 10.7% (19) with low-grade squamous intraepitheliallesions (LSIL), and 1.13% with high-grade squamous intraepithelial lesions (HSIL). The cytological evaluation wasan unsatisfactory result only with 6.67%. The present modified LBC using 95% ethyl alcohol as the preservativecould thus be used for anal cancer screening. The number of SILs in Thai HIV-infected patients is lower thanthat in Western countries. We found anal cytology a satisfactory tool for early screening and detection of analdysplasia commonly found in high-risk, HIV-infected patients.http://journal.waocp.org/article_26877_311692dce46236afb0ebfb1e6cee4b9b.pdf2012-09-01T11:23:202017-12-14T11:23:2044874490Anal carcinomaHIVScreeningCytologyORIGINAL_ARTICLEDetermination of Information and Support Needs of First Degree Relatives of Women with Breast CancerBackground: Breast cancer is the most frequent type of cancer among women in the world and the mostcommon cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the mostfrequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women havingbreast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attemptto determine the information and support needs of women whose first-degree relatives have breast cancer andto what extent these needs are met. Methods: The research sample consisted of 156 women. Questionnaire Formand Information and Support Needs Questionnaires were used as the data collection tools. Results: Informationneed score averages (x̄:3.72±0.19) of women included in the research sampling were found to be higher than theirscore averages of support needs (x̄:3.24±0.41). Conclusion: Information needs which were indicated by womenas very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), whilesupport needs which were indicated by women as very important were learning how to perform BSE, women’sanxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a healthprofessional. It is recommended that nurses and other medical staff should give information to women whosefirst-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment optionsand protection as well as prevention.http://journal.waocp.org/article_26878_5676f22b5cd712bab1999eb48509bad1.pdf2012-09-01T11:23:202017-12-14T11:23:2044914499Women at high risk of breast cancerinformation and support needsnursing interventionORIGINAL_ARTICLETime Trends of Esophageal Cancer Mortality in Linzhou City During the Period 1988-2010 and a Bayesian Approach Projection for 2020In recent decades, decreasing trends in esophageal cancer mortality have been observed across China.We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophagealcancer in China, during 1988–2010 and make a esophageal cancer mortality projection in the period 2011–2020using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to theWorld population structure in 1985. A Bayesian age–period–cohort (BAPC) analysis was carried out in orderto investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during1988–2010 and to estimate future trends for the period 2011–2020. Age-adjusted rates for men and womendecreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the veryelderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showedrisk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden ofmortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decreaseof esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomicenvironment and lifestyle. The standardized mortality rates of esophageal cancer should decreasecontinually. The effect of aging on the population could explain the increase in esophageal mortality projectedfor 2020.http://journal.waocp.org/article_26879_12b8a482c1cca791e5d9c600aed572a2.pdf2012-09-01T11:23:202017-12-14T11:23:2045014504Esophageal cancerMortalityLinzhouBayesian APC modelprojectionORIGINAL_ARTICLEPost-operative Treatment with Cisplatin and Vinorelbine in Chinese Patients with Non-small Cell Lung Cancer: A Clinical Prospective Analysis of 451 PatientsPurpose: To determine the efficacy of post-operative chemotherapy with cisplatin plus vinorelbine (NP) inChinese patients with non-small cell lung cancer (NSCLC). Methods: A total of 451 patients with NSCLCs atstages I, II, and IIIA after surgical resection were treated with cisplatin plus vinorelbine for 4 cycles or volunteersobserved between January 2002 and November 2004 and were followed for five years. The therapeutic efficacywas evaluated with reference to overall survival (OS) and disease-free survival (DFS), and adverse effects werealso recorded. Potential factors affecting the lengths of OS and DFS were analyzed by multivariate analysis.Results: Most patients (86.7%) completed at least 4 cycles of treatment. Patients with chemotherapy survivedsignificantly longer than those in the observation group (p<0.001). The absolute improvements in the 2 and 5-yearOS were 3.8% [hazard ratio (HR) =0.674, 95% confidence interval (CI): 0.554-0.820, P<0.0001] and 13.0%(HR=0.732, 95% CI: 0.579-0.926, P=0.009), respectively. The improvement at 4-year DFS was 2.1% (HR=0.327,95% CI: 0.214-0.500, P<0.0001). Stratification analysis revealed that older age, histological type, pathologicaldegree, but not the gender and smoking status, are independent factors affecting the length of survival in thispopulation. Many patients (63.3%) had grade 1-III tolerable adverse effects, and there was no treatment-relateddeath. Conclusions: Post-operative chemotherapy with NP regimen is effective and tolerable in Chinese patientswith NSCLC.http://journal.waocp.org/article_26880_4f063f07cac866bc0ed415ef6832120e.pdf2012-09-01T11:23:202017-12-14T11:23:2045054510non-small cell lung cancercisplatinvinorelbineSurvivalORIGINAL_ARTICLECauses of Delay in Seeking Treatment in Patients with Breast Cancer in Iran: a Qualitative Content Analysis StudyBackground: In the Middle East, including Iran, breast cancer is the most frequent malignancy among women.Without treatment, a malignant breast tumor advances in stage, diminishing a woman’s chances of survival. Inthis study we aimed to gain insight into the causes of delay in seeking treatment in patients with breast cancer.Methods: The participants in this qualitative, content analysis study were 10 women in whom a diagnosis ofbreast cancer in the stages of II b, III or IIV had been made. They were selected from patients of a major oncologyclinic in Kerman, Iran. Data were collected by means of semi-structured interviews that lasted between 20 to30 minutes. Sampling was discontinued when data saturation was achieved. Content analysis was conductedby classifying the data into themes and sub-themes. Results: The results of our study revealed several factorsthat interfered with patients’ professional consultation seeking and prompt treatment. These factors included;lack of knowledge, fear of being diagnosed with cancer, not seeing oneself at risk, mental preoccupation andwrong diagnosis by physicians. Conclusions: This study suggests that women and even physicians need furtherinformation about breast cancer symptoms. Women need encouragement to seek medical advice when theyencounter suspicious symptoms. Additionally, women may benefit from awareness of the pros of early detectionand reassurance about the improvements in the success of breast cancer treatment.http://journal.waocp.org/article_26881_c172769c98a88e75120d093158a8b4c3.pdf2012-09-01T11:23:202017-12-14T11:23:2045114515Breast cancersymptomsDelayKermanIranORIGINAL_ARTICLEEpidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?Introduction: Northeastern Iran is known as a high risk area of upper gastrointestinal cancers. Recent reportshave suggested a declining trend for these cancers as well as an increase in the incidence of other malignanciesincluding breast cancer. Our present aim was to describe the epidemiological pattern of breast cancer in thisregion during 2004-2009. Methods: All new cancer cases from public and private diagnostic and therapeuticcenters of Golestan province were registered. A structured questionnaire was prepared and used based on thestandards of the International Association of Cancer Registries. The international classification of diseases foroncology was considered for coding. Age standardized incidence rates (ASR) of breast cancer were calculated.Results: A total of 11,038 new cancer cases were registered during 2004-2009, of which, 1,101 (10%) were femaleswith breast cancer. The median age of the breast cancer patients was 46 years. The ASR for breast cancer was 28per 100,000 person-years. We found an unusual rapid increase in breast cancer rate at the age of 25 years. TheASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas (Pvalue <0.01). Conclusion: Our study showed high rate of breast cancer in Golestan province of Iran. We foundan unusual peak of breast cancer in young women. So, the age of starting screening programs may need to berevised in this area. The rate of breast cancer was significantly lower in women from Turkmen ethnicity. Furtherstudies are warranted to clarify the role of important determinants, especially regarding the ethnic disparity,on breast cancer in this region.http://journal.waocp.org/article_26882_cdec75faf333e5ab99c0fd5e5d5a8ef6.pdf2012-09-01T11:23:202017-12-14T11:23:2045174520Breast cancerEpidemiologyethnic disparityIranORIGINAL_ARTICLEImproved Accuracy of Cytodiagnosis using the Kato Self-Collection Devise: the Usefulness of Smear Preparation in Liquid-based Cytology MethodsObject: In the present study, we compared the positive cytodiagnostic test rates with discrepancies usingself-collection devices for cervical cancer screening. We made this survey to examine whether or not our selfsmearpreparation method using the Kato self-collection device contributed to an improved rate of detectingatypical cells compared with existing recommended preparation methods. Methods: Specimens were collected at14 facilities handling self-collection methods, and samples were collected by a physician in 2 facilities. The chisquaredtest was performed using the SPSS ver. 20 statistical software to determine the relationships between thepositive cytodiagnostic rate, specimen preparation methods, and self-collection devices. Results: Collecting cellsusing the Kato self-collection device and preparing liquid-based specimens, we obtained a significantly higherrate of positive cytodiagnosis and our results were equal to those obtained with the direct method. Conclusions:Taking into consideration increased needs for screening using the self-collection method in future, with evenmore improved test accuracy, a screening test that is acceptable to society needs to be established.http://journal.waocp.org/article_26883_3672f58400b16004ae53998bafdfe53d.pdf2012-09-01T11:23:202017-12-14T11:23:2045214524cervical cytologyKato self-collection deviceLiquid-based cytologyORIGINAL_ARTICLEOvarian Metastasis and other Ovarian Neoplasms in Women with Cervical Cancer Stage IA-IIAObjectives: To determine the prevalence and predicting factors of ovarian metastasis, and evaluate thehistology of other ovarian neoplasms in women with early-stage cervical cancer. Methods: The medical recordsof women with cervical cancer stage IA-IIA who underwent primary surgical treatment at Siriraj Hospital,Mahidol University from January 2007 to December 2011 were used for the study. Demographic, clinical andhistopathologic data of the women who underwent salpingo-oophorectomy were reviewed. Results: Of 264women, the mean age was 52.3 years. The types of hysterectomy procedures were composed of 210 radicalhysterectomy, 9 modified radical hysterectomy, 40 simple hysterectomy, and 5 abandoned hysterectomy. Theprevalence of ovarian metastasis was 0.76% (2/264). All of ovarian metastatic patients were older than 60 yearsold, postmenopause, and had macroscopical stage IB1 cervical cancer. Others ovarian tumors were foundin 7 patients including 1 synchronous ovarian carcinoma, 1 serous cystadenoma, 1 fibroma, and 4 teratoma.Conclusions: In cases of early-stage cervical carcinoma of the population studied, ovarian preservation couldbe another option in <60-year-old patients, with non-neuroendocrine cell type, stage IA, and no extracervicalor ovarian lesions.http://journal.waocp.org/article_26884_51dda25360c4d8af8fbf7642ba939244.pdf2012-09-01T11:23:202017-12-14T11:23:2045254529cervical cancerearly-stageovarian metastasissurgeryovarian preservationORIGINAL_ARTICLEIntervention Effects of Nedaplatin and Cisplatin on Proliferation and Apoptosis of Human Tumour Cells in VitroObjective: To study synergistic effects of nedaplatin and cisplatin on three human carcinoma cell lines(esophageal carcinoma cell line Eca-109, ovarian carcinoma Skov-3 and cervical carcinoma Hela). Methods:Inhibition effects were evaluated by MTT assay and cell apoptosis was detected by flow cytometry. In addition,changes of Ki-67, Bax and Bcl-2 at mRNA and protein levels were quantified by RT-PCR and Western blotting.Results: Growth inhibition in each cell lines was dose-dependent after exposure to nedaplatin or cisplatinalone. The interaction of the two drugs was synergistic at higher concentrations according to the median-effectprinciple. The inhibition rates with nedaplatin, cisplatin and combined treatment were 41.9±4.1%, 47.4±2.9%,52.5±0.9%(Eca-109), 39.0±1.26%, 45.0±1.45% , 56.2±1.44% (Skov-3) and 44.8±2.11%, 46.9±0.99%, 56.6±1.83%(Hela) respectively, with increase in apoptosis. Compared with the nedaplatin or cisplatin alone treatment group,the combinative treatment group’s Ki-67 and bcl-2 mRNA (protein) expression was decreased while that of BaxmRNA (protein) was increased. Conclusion: Compared to the effects of nedaplatin or cisplatin alone at highconcentrations, combination of nedaplatin and cisplatin at low concentrations proved to be much more effectivefor inhibition of proliferation and the induction of apoptosis in the Eca-109, Skov-3 and Hela cell lines.http://journal.waocp.org/article_26885_db57bbd766fd7555a713d38b7e8d821f.pdf2012-09-01T11:23:202017-12-14T11:23:2045314536Nedaplatin/cispaltin combined treatmentCarcinomaesophagusOvariesCervixmedian-effect principleORIGINAL_ARTICLERole of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in IranBackground: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow anindolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiologicalpresentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzedclinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghanihospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors.The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients,cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization offunctional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and latestages and cystic lesions were more common in this group.http://journal.waocp.org/article_26886_3bc3e79ae398acb0757f3c8a7bebfe24.pdf2012-09-01T11:23:202017-12-14T11:23:2045374540pNETEUSCTDiagnosisORIGINAL_ARTICLEElevated Serum Haptoglobin is Associated with Clinical Outcome in Triple-Negative Breast Cancer PatientsBackground: Breast cancer is the most common malignancy with the highest incidence rates among womenworldwide. Triple-negative breast cancer (TNBC) disease is diagnosed more frequently in younger women, andis associated with a poor prognosis. Elevated levels of serum haptoglobin protein (Hp) are observed in manymalignant diseases including breast cancer. We evaluated the expression and prognostic value of Hp amongpatients with TNBC. Materials and Methods: Serum Hp levels were determined by Elisa in 41 patients withTNBC and 10 normal individuals. Hp status was correlated with other clinico-pathological parameters includingpatient survival. Results: Of the 41 patients with TNBC, Hp over expression was detected in 24 (59%) by Elisa.Hp up-regulation was confirmed by Elisa based quantification in the serum of 41 TNBC patients against lowergrades and 10 normal individuals. Survival analysis revealed that Hp (p=2.016x10-5), stage (p=2.166x10-5), distantmetastasis (p=2.217x10-5), tumor size (p=1.053x10-5), and tumor grade (p=0.001), correlated with patient survivalon univariate analysis. Multivariate analysis revealed that Hp (p=0.001), and grade of the disease (p=0.008)were independent predictors of survival. Conclusion: Our results indicate that serum levels of Hp may play arole as a potential serum biomarker and prognostic indicator among TNBC patients. Thus, Hp may presenta new promising prognostic biomarker in TNBC patients, but independent validations are now necessary forconfirmation.http://journal.waocp.org/article_26887_601f5f05c37085b80ae0f66f28090d74.pdf2012-09-01T11:23:202017-12-14T11:23:2045414544triple negative breast cancerHpprognosisTNBCORIGINAL_ARTICLESerum Level of MMP-3 in Patients with Oral Squamous Cell Carcinoma - Lack of Association with Clinico-pathological FeaturesBackground: MMP-3 is a proteolytic enzyme of the matrix metalloproteinase family. Protein degradationwhich is their fundamental action regulates different activities of tumor cell such as their growth, differentiation,apoptosis, migration, invasion, angiogenesis as well as their resistance to the immune system. Aim: The aim ofthis study was to determine MMP-3 serum levels in patients with OSCC and investigate if they correlate withclinicopathological features. Method and materials: Using an ELISA kit, we assessed and compared the circulatinglevels of MMP-3 in blood serum of 45 oral squamous cell carcinoma patients with 45 healthy control samples.Results: The serum MMP-3 level in OSCC patients was significantly higher (9.45±4.6 ng/ml) than healthycontrols (5.9±3.6 ng/ml, p<0.001), especially in females and in older patients. However, there was no apparentcorrelation in serum MMP-3 concentration with the clinico-pathological features such as tumor location, stage,tumor size, nodal status, distant metastasis, histological grade and smoking. Discussion: This result suggeststhat the measurement of serum MMP-3 concentration might be helpful to diagnose OSCC but not to predictprognosis.http://journal.waocp.org/article_26888_8ed1db41163048a6a9857c4cb4c6fec9.pdf2012-09-01T11:23:202017-12-14T11:23:2045454548MMP-3serumOral Squamous Cell CarcinomaDiagnosisprognosisORIGINAL_ARTICLEImpact of CYP2D6 Polymorphisms on Tamoxifen Responses of Women with Breast Cancer: A Microarray-based Study in ThailandThis study was designed to investigate the frequency of CYP2D6 polymorphisms and evaluate the associationbetween genetic polymorphisms of CYP2D6 and tamoxifen therapeutic outcome in Thai breast cancer patients.We recruited 48 breast cancer patients who received adjuvant tamoxifen for evaluating CYP2D6 geneticpolymorphisms using microarray-based technology. Associations between genotypes-phenotypes and diseasefree survival were analyzed. Median follow up time was 5.6 years. The mean age of the subjects was 50 years.The 3 common allelic frequencies were 43.8% (*10), 36.5 (*1) and 10.4% (*2) which are related to extensivemetabolizer (EM) and intermediate metabolizer (IM) with 70.8% and 29.2 %, respectively. No associationbetween CYP2D6 genotypes and DFS was demonstrated. Nevertheless, exploratory analysis showed statisticallysignificant shorter DFS in the IM group of post-menopause patients (HR, 6.85; 95% CI, 1.48 –31.69; P = 0.005).Furthermore, we observed statistically significant shorter DFS of homozygous CYP2D6*10 when comparedwith heterozygous CYP2D6*10 and other genotypes (P=0.005). CYP2D6*10 was the most common genotype inour subjects. Post-menopause patients with homozygous CYP2D6*10 and IM have shorter DFS. To confirm thisrelationship, larger samples and comprehensively designed trials in Thailand are required.http://journal.waocp.org/article_26889_8b1684ad81386f0ade6f0849791daf54.pdf2012-09-01T11:23:202017-12-14T11:23:2045494553Breast cancerCYP2D6 polymorphismsTamoxifenpharmacogeneticsmicroarrayThailandORIGINAL_ARTICLEOleuropein Induces Anti-metastatic Effects in Breast CancerBreast cancer causes death due to distant metastases in which tumor cells produce matrix metalloproteinase(MMP) enzymes which facilitate invasion. Oleuropein, the main olive oil polyphenol, has anti-proliferative effects.This study aimed to investigate the effect of oleuropein on the metastatic and anti-metastatic gene expression inthe MDA human breast cancer cell line. We evaluated the MMPs and TIMPs gene expression by semi-quantitativereverse transcriptase polymerase chain reaction (RT-PCR) in treated and untreated cells. This study demonstratedthat OL may induce anti-metastatic effects on human breast cancer cells. We found that TIMP1,-3, and -4 wereover-expressed after all periods of incubation in treated cancer cells compared to untreated cells, while MMP2and MMP9 genes were down-regulated, at least initially. Treatment of breast cancer cells with oleuropein couldhelp in prevention of cancer metastasis by increasing the TIMPs and suppressing the MMPs gene expressions.http://journal.waocp.org/article_26890_6edc6021d783f543d4fcecb3fdfdedd7.pdf2012-09-01T11:23:202017-12-14T11:23:2045554559Breast cancer &#8211oleuropein - metastasis - TIMPs expression - MMPs expressionORIGINAL_ARTICLEPsychological Treatment for Pain Among Cancer Patients by Rational-Emotive Behavior Therapy - Efficacy in both India and IranThe aim of the present study is to find out the influence of rational-emotive behavior therapy (REBT) on painintensity among cancer patients in India and Iran. The study followed a quasi-experimental, pre-post test, carriedout with a sample of 88 cancer patients, aged 21-52 years, referred to the Baharat cancer hospital of Mysore inIndia and Shahidzade hospital of Behbahan in Iran. They were randomly assigned to the experimental (n=India21; Iran 22) and control (n=India 22; Iran 23) groups. Pain was measured with the McGill Pain Questionnaire-MPQ (1975), the intervention by REBT has given to the experimental group for 45 days (ten sessions) and atthe end of intervention, the pain of patients was again evaluated. Concerning to hypothesis of the study, twoindependent sample T test and three ways mixed ANOVA is used to analyze the data. Results showed that theexperimental group in post test had less pain than the control group, but there were no statistically significantdifferences between Indian and Iranian patients in pain perception. With respect the outcome of study, it hasrealized that REBT can be used in hospitals and other psychological clinics to reduce the pain of cancer patients.http://journal.waocp.org/article_26891_3c3cb32d57f824ae51a37357380870a0.pdf2012-09-01T11:23:202017-12-14T11:23:2045614565Interventionrational emotive behavior therapy (REBT)PainCancer patientsIndiaIranORIGINAL_ARTICLEClinicopathologic Importance of Women with Squamous Cell Carcinoma Cytology on Siriraj Liquid-Based Cervical CytologyObjectives: The purposes of this study were to determine the prevalence and predictive value to detectsignificant neoplasia and invasive lesions, and to evaluate the correlation between clinical and histopathology ofwomen with squamous cell carcinoma (SCCA) on Siriraj liquid-based cervical cytology (Siriraj-LBC). Methods:The computerized database of women who underwent Siriraj-LBC at Siriraj Hospital, Mahidol Universityfrom January 2007 to December 2010 were retrieved. The hospital records of women with SCCA cytology werereviewed. Results: The prevalence of SCCA cytology was 0.07%. A total of 86 women, mean age was 58.1 years.Sixty-one women (70.9%) were post-menopausal. Overall significant pathology and invasive gynecologic cancerwere detected in 84 women (97.7%) and 71 women (82.5%), respectively. The positive predictive values fordetection of significant neoplasia and invasive lesion were 97.7% and 82.6%, respectively. The cervical cancerwas diagnosed in 69 women and among these 58 women were SCCA. Thirteen women (15.1%) had cervicalintraepithelial neoplasia (CIN) 3 and two women (2.3%) had cervicitis. The sensitivity and specificity of colposcopyfor cervical cancer detection in SCCA cytology were 83.3% and 75%, respectively. Median follow up period was17.6 months and 64 patients were alive without cytologic abnormality. Conclusions: The final histopathology ofSCCA cytology in our populations demonstrated a wide variety, from cervicitis to invasive cancer and the mostcommon diagnosis was invasive cervical cancer. Colposcopy with biopsy and/or endocervical curettage and loopelectrosurgical excision procedure should be undertaken to achieve histologic diagnosis.http://journal.waocp.org/article_26892_01937b68ab6af16aea2235a7d93642a7.pdf2012-09-01T11:23:202017-12-14T11:23:2045674570squamous cell carcinomaCervixLiquid-based cytologycolposcopypathologyORIGINAL_ARTICLEClinicopathological Features in Bilateral Breast CancerIntroduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers.It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breastcancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics,treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronousand comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fiftybilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned.Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant,surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and secondoccurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showedsimilar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage,ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates wereidentified as significantly different. Palliative chemotherapy response rate was greater in the metachronousgroup but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer isnot frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, lessER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapyin case of relapse/metastasis.http://journal.waocp.org/article_26893_309636d1122391d9ef1a84bc70c40f27.pdf2012-09-01T11:23:202017-12-14T11:23:2045714575Bilateral breast cancerSynchronousMetachronousclinicopathological characteristicsTurkeyORIGINAL_ARTICLEProstate Cancer in Younger and Older Patients: Do We Treat Them Differently?Diagnostic and therapeutic strategies of prostate cancer may largely influenced by patients’ age at presentation.This study is aimed to evaluate the characteristics, diagnostic and treatment strategies in prostate cancer patientsin our centres. A cross-sectional analytic study of prostate cancer data in two main referral cancer centres,Cipto Mangunkusumo General Hospital and Dharmais National Cancer Centre from 1995-2010, was thereforeperformed. Patients were divided into 2 sub-populations; below 60 years (younger patients) and 75 years old andabove (older patients). PSA levels, diagnostic modalities, Gleason score and therapeutic options were analysed forboth and compared using bivariate analysis. 152 patients were <60 years and 210 were ≥75 years. There was nostatistical difference in mean PSA level (797.9ng/mL vs 345.3 ng/mL, respectively; p>0.05) and diagnosis was madeby biopsy in majority of patients in both groups (68.2% and 71.6% in younger and older groups respectively).Most presented with an advanced disease stage (65.1% and 66.0%, respectively) and there was no statisticallysignificant difference in mean Gleason scores f (8.1 vs 7.7; p>0.05). Primary androgen deprivation therapy(PADT) was the main treatment for overall patients (48.0% and 50.7%, respectively). Radiotherapy and radicalprostatectomy are the main therapeutic modalities for younger patients with local and locally advanced disease(39.6% and 35.4% respectively), while the majority of older patients with the same disease stage were treatedwith radiotherapy and PADT (45.8% and 39.0% respectively). Differences observed in treatment modalitieswere statistically significant (p<0.0003). We conclude that there is no difference in disease clinical aggressivenessof the two groups but significant differences were obseved in therapeutic strategies utilised with younger andolder patients.http://journal.waocp.org/article_26894_6bde5d80e494e0d97c776808087f1959.pdf2012-09-01T11:23:202017-12-14T11:23:2045774580Prostate CancerYoungElderlytreatmentclinical agressivenessindonesiaORIGINAL_ARTICLEMolecular Characterization of FLT3 Mutations in Acute Leukemia PatientsFms-like tyrosine kinase 3 (FLT3) performs a vital role in the pathogenesis of hematopoietic malignancies.Therefore in recent times, the focus of several studies was on use of FLT3 as a prognostic marker. The presentstudy investigated the molecular characterization and incidence of FLT3 mutations in acute leukemia patients inPakistan. A total of 55 patients were studied, of which 25 were suffering from acute lymphoblastic leukemia (ALL)and 30 were suffering from acute myeloid leukemia (AML). The polymerase chain reaction demonstrated FLT3/ITD mutations in 1 (4%) of 25 ALL patients, a male with the L2 subtype. In AML cases the rate was 4 (13.3%) of30, three males and one female. The AML-M4 subtype was found in three and the AML M2 subtype in the other.In the AML cases, a statistically significant (p=0.009) relationship was found between WBC (109/L) and FLT3/ITD positivity. However, no significant relationship was found with other clinical parameters (p>0.05). In acutemyeloid leukemia (AML) FLT3/ITD+ mutation was more prevalent in elderly patients 31-40 age groups, 21-30and 51-60 age groups respectively. In acute lymphoblastic leukemia (ALL) statistically no significant relationshipwas found between clinical features and FLT3/ITD positivity (p>0.05). However, in acute lymphoblastic leukemia(ALL) FLT3/ITD+ mutation was more commonly found in age groups of 21-30.http://journal.waocp.org/article_26895_af1a3bcbe2f382c3eeac9d88e8cf26e4.pdf2012-09-01T11:23:202017-12-14T11:23:2045814585Acute leukemiaFLT3/ITDFAB subtypesORIGINAL_ARTICLEPoor Treatment Outcome of Neuroblastoma and OtherPeripheral Nerve Cell Tumors May be Related to Under Usage of Radiotherapy and Socio-Economic Disparity: A US SEER Data AnalysisPurpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiologyand End Results (SEER) neuroblastoma (NB) and other peripheral nerve cell tumors (PNCT) outcome data.This study found under usage of radiotherapy in these patients. Materials and methods: This study analyzedsocio-economic, staging and treatment factors available in the SEER database for NB and other PNCT. For therisk modeling, each factor was fitted by a generalized jinear model to predict the outcome (soft tissue specificdeath, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar stratawere combined to construct the most parsimonious models. A random sampling algorithm was used to estimatethe modeling errors. Risk of neuroendocrine (other endocrine including thymus as coded in SEER) death wascomputed for the predictors. Results: There were 5261 patients diagnosed from 1973 to 2009 were included inthis study. The mean follow up time (S.D.) was 83.8 (97.6) months. The mean (SD) age was 18 (25) years. About30.45% of patients were un-staged. The SEER staging has high ROC (SD) area of 0.58 (0.01) among the factorstested. We simplified the 4-layered risk levels (local, regional, distant, un-staged/others) to a simpler 3-tieredmodel with comparable ROC area of 0.59 (0.01). Less than 50% of PNCT patients received radiotherapy (RT)including the ones with localized disease. This avoidance of RT use occurred in adults and children. Conclusion:The high under-staging rate may have prevented patients from selecting definitive radiotherapy (RT) aftersurgery. Using RT for, especially, adult PNCT patients is a potential way to improve outcome.http://journal.waocp.org/article_26896_53034b731651aed5596d5492109b783a.pdf2012-09-01T11:23:202017-12-14T11:23:2045874592Peripheral nerve cell tumorsneuroblastomaradiotherapySEER registryunder useORIGINAL_ARTICLEComparison of Teaching about Breast Cancer via Mobile or Traditional Learning Methods in Gynecology ResidentsIntroduction: Mobile learning enables users to interact with educational resources while in variable locations.Medical students in residency positions need to assimilate considerable knowledge besides their practical trainingand we therefore aimed to evaluate the impact of using short message service via cell phone as a learning toolin residents of Obstetrics and Gynecology in our hospital. Methods: We sent short messages including dataabout breast cancer to the cell phones of 25 residents of gynecology and obstetrics and asked them to study awell-designed booklet containing another set of information about the disease in the same period. The rate oflearning derived from the two methods was compared by pre- and post-tests and self-satisfaction assessed by arelevant questionnaire at the end of the program. Results: The mobile learning method had a significantly bettereffect on learning and created more interest in the subject. Conclusion: Learning via receiving SMS can be aneffective and appealing method of knowledge acquisition in higher levels of education.http://journal.waocp.org/article_26897_7cc0c57d2e9c7da35f8314d588d4995e.pdf2012-09-01T11:23:202017-12-14T11:23:2045934595Breast neoplasmcancer educationMedical Educationmobile learningsmall message serviceORIGINAL_ARTICLECytotoxicity, Toxicity, and Anticancer Activity of Zingiber Officinale Roscoe Against CholangiocarcinomaCholangiocarcinoma (CCA) is an uncommon adenocarcinoma which arises from the epithelial cells of thebile ducts. The aim of the study was to investigate the cytotoxicity, toxicity, and anticancer activity of a crudeethanolic extract of ginger (Zingiber officinale Roscoe) against CCA. Cytotoxic activity against a CCA cell line(CL-6) was assessed by calcein-AM and Hoechst 33342 assays and anti-oxidant activity was evaluated using theDPPH assay. Investigation of apoptotic activity was performed by DNA fragmentation assay and induction ofgenes that may be involved in the resistance of CCA to anticancer drugs (MDR1, MRP1, MRP2, and MRP3)was examined by real-time PCR. To investigate anti-CCA activity in vivo, a total of 80 OV and nitrosamine (OV/DMN)-induced CCA hamsters were fed with the ginger extract at doses of 1000, 3000, and 5000 mg/kg bodyweight daily or every alternate day for 30 days. Control groups consisting of 10 hamsters for each group werefed with 5-fluorouracil (positive control) or distilled water (untreated control). Median IC50 (concentration thatinhibits cell growth by 50%) values for cytotoxicity and anti-oxidant activities of the crude ethanolic extract ofginger were 10.95, 53.15, and 27.86 μg/ml, respectively. More than ten DNA fragments were visualized and upto 7-9 fold up-regulation of MDR1 and MRP3 genes was observed following exposure to the ethanolic extractof ginger. Acute and subacute toxicity tests indicated absence of any significant toxicity at the maximum dose of5,000 mg/kg body weight given by intragastric gavage. The survival time and survival rate of the CCA-bearinghamsters were significantly prolonged compared to the control group (median of 54 vs 17 weeks). Results fromthese in vitro and in vivo studies thus indicate promising anticancer activity of the crude ethanolic extract ofginger against CCA with the absence of any significant toxicity. Moreover, MDR1 and MRP3 may be involvedin conferring resistance of CCA to the ginger extract.http://journal.waocp.org/article_26898_2c45eb83beee65325e9216459d375122.pdf2012-09-01T11:23:202017-12-14T11:23:2045974606CholangiocarcinomacytotoxicitygingerZingiber Officinale roscoeORIGINAL_ARTICLEWeighted Gene Co-expression Network Analysis in Identification of Endometrial Cancer Prognosis MarkersObjective: Endometrial cancer (EC) is the most common gynecologic malignancy. Identification of potentialbiomarkers of EC would be helpful for the detection and monitoring of malignancy, improving clinical outcomes.Methods: The Weighted Gene Co-expression Network Analysis method was used to identify prognostic markersfor EC in this study. Moreover, underlying molecular mechanisms were characterized by KEGG pathwayenrichment and transcriptional regulation analyses. Results: Seven gene co-expression modules were obtained,but only the turquoise module was positively related with EC stage. Among the genes in the turquoise module,COL5A2 (collagen, type V, alpha 2) could be regulated by PBX (pre-B-cell leukemia homeobox 1)1/2 andHOXB1(homeobox B1) transcription factors to be involved in the focal adhesion pathway; CENP-E (centromereprotein E, 312kDa) by E2F4 (E2F transcription factor 4, p107/p130-binding); MYCN (v-myc myelocytomatosisviral related oncogene, neuroblastoma derived [avian]) by PAX5 (paired box 5); and BCL-2 (B-cell CLL/lymphoma 2) and IGFBP-6 (insulin-like growth factor binding protein 6) by GLI1. They were predicted to beassociated with EC progression via Hedgehog signaling and other cancer related-pathways. Conclusions: Thesedata on transcriptional regulation may provide a better understanding of molecular mechanisms and clues topotential therapeutic targets in the treatment of EC.http://journal.waocp.org/article_26899_6f59614b9ded3dff94e61387bc5541db.pdf2012-09-01T11:23:202017-12-14T11:23:2046074611endometrial cancerCo-expression moduleKEGGtranscriptional regulationORIGINAL_ARTICLEAnalysis of Esophageal Cancer Time Trends in China, 1989-2008National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in orderto provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophagealcancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008.Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent changeestimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer wasfound to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardizedincidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 inall areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annualdecrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreasedwith 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer agestandardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is stilla big issue and efforts for control should be continuously enhanced. Cancer registration is playing an importantrole in cancer control with the number of registries increasing and data quality improving in China.http://journal.waocp.org/article_26900_2a406187247102b9f88554b38e202e64.pdf2012-09-01T11:23:202017-12-14T11:23:2046134617Esophageal cancerincidenceTrend Analysiscancer registryChinaORIGINAL_ARTICLEIs Level Ⅴ Dissection Necessary for Low-risk Patients with Papillary Thyroid Cancer Metastasis in Lateral Neck Levels II, III, and IVWhether it is beneficial to dissect level Ⅴ in papillary thyroid cancer (PTC) patients with positive lateralneck lymph nodes at levels II-IV is still controversial, especially for low risk cases. In this study, we reviewedthe medical records of 47 patients who underwent 47 ipsilateral selective lateral neck dissections (levels Ⅱ-Ⅳ)for previously untreated papillary thyroid carcinomas between October 2006 and October 2008 to assist inestablishing the optimal strategy for lateral neck dissection in low risk PTC patients with clinically negativelevel V nodes. All 47 patients were confirmed to have positive lymph nodes pathologically. Seventeen (36.12%),36 (76.6%), and 34 (72.34%) patients had positive lymph nodes in levels II, III, and IV, respectively. The meannumber of pathologically positive lymph nodes was 1.7 in level II, 2.9 in level III, 2.8 in level IV. No death anddistant metastasis were recorded during follow up period. Just 2 patients exhibited recurrence to lymph nodes,and only one showed nodal recurrence in ipsilateral level V, who had positive lymph nodes in all of levels II, III,and IV at initial neck surgery. In conclusion, for PTC low risk patients with clinically negative lymph nodes inlevel V, non-performance of level V dissection would still achieve good survival results as traditional modifiedradical neck dissection, with a “wait and see” strategy to be recommended.http://journal.waocp.org/article_26901_fb4c5c37bd75b52d5beea8ea37d6e0fc.pdf2012-09-01T11:23:202017-12-14T11:23:2046194622Papillary cancerlymph node dissection level VThyroidORIGINAL_ARTICLERisk of Treatment Related Death and Febrile Neutropaenia with Taxane-Based Adjuvant Chemotherapy for Breast Cancer in a Middle Income Country Outside a Clinical Trial SettingBackground: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxanebasedchemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years.This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC).Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breastcancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry.The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as deathoccurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment.FN was defined as an oral temperature >38.5°C or two consecutive readings of >38.0°C for 2 hours and anabsolute neutrophil count <0.5x109/L, or expected to fall below 0.5x109/L. Results: A total of 622 patients receivedadjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimenemployed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there wasno TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.http://journal.waocp.org/article_26902_5cb65d77c49e846fac153eeb3f3ea2c5.pdf2012-09-01T11:23:202017-12-14T11:23:2046234626Treatment related death (TRD)febrile neutropaenia (FN)Breast cancerAdjuvant chemotherapyORIGINAL_ARTICLEMTHFR Gene Polymorphisms are Not Involved in Pancreatic Cancer Risk: A Meta-analysisPurpose: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms have been reported to beassociated with pancreatic cancer, but the published studies have yielded inconsistent results. This study assessedthe relationship between MTHFR gene polymorphisms and the risk for pancreatic cancer using a meta-analysisapproach. Methods:A search of Google scholar, PubMed, Cochrane Library and CNKI databases before April 2012was performed, and then associations of the MTHFR polymorphisms with pancreatic cancer risk were summarized.The association was assessed by odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was alsocalculated. Results: Four relative studies on MTHFR gene polymorphisms (C667T and A1298C) were included inthis meta-analysis. Overall, C667T (TT vs. CC:OR=1.61,95%CI=0.78-3.34; TT vs. CT: OR=1.41,95%CI=0.88-2.25;Dominant model:OR=0.68,95%CI=0.40-1.17; Recessive model: OR=0.82,95%CI=0.52-1.30) and A1298C (CCvs. AA:OR=1.01,95%CI=0.47-2.17; CC vs. AC: OR=0.99,95%CI=0.46-2.14; Dominant model:OR=1.01,95%CI=0.47-2.20; Recessive model: OR=1.01,95%CI=0.80-1.26) did not increase pancreatic cancer risk.Conclusions: This meta-analysis indicated that MTHFR polymorphisms (C667T and A1298C) are not associatedwith pancreatic cancer risk.http://journal.waocp.org/article_26903_120a6376144732fad5ab6ebbc0f91e04.pdf2012-09-01T11:23:202017-12-14T11:23:2046274630Pancreatic cancerMTHFRGene PolymorphismMeta-analysisORIGINAL_ARTICLETobacco Control Law Enforcement and Compliance in Odisha, India - Implications for Tobacco Control Policy and PracticeIntroduction: Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh peoplein 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha,non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reducesthe capacity to seek better nutrition, medical care and education. In line with the WHO Framework Conventionon Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indiannational law on tobacco control. The Government of Odisha has shown its commitment towards enforcementand compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco controlefforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selecteddistricts. Materials and methods:A semi-structured interview schedule was developed, translated into Odiya andfield-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 ofCOTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selectedprovisions of the Act. 1414 samples were interviewed. Results: The highest percentage of respondents was fromthe government departments. 70% of the illiterates consumed tobacco as compared to 34% post graduates.52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about theprovision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that theyhad ‘very often’ seen tobacco products being sold ‘to a minor’, while 31.2% had seen tobacco products beingsold ‘by a minor’. In addition, 24.8% had ‘very often’ seen tobacco products being sold within a radius of 100yards of educational institutions.http://journal.waocp.org/article_26904_247136a022265d80d703b81ce3894fb3.pdf2012-09-01T11:23:202017-12-14T11:23:2046314637Tobacco control policytobacco control lawComplianceenforcementOdishaIndiaORIGINAL_ARTICLELung Cancer in Malabar Cancer Center in Kerala - A Descriptive AnalysisThe burden of lung cancer in terms of mortality is the highest among all types of cancers globally. Thepresent study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lungcancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010.A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer casesin 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smokinghabit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accountedfor 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasisand the remainder had regional lymph node involvement. However, no statistically significant difference wasobserved for secondary site of tumor according to gender. As majority of the cases reported at MCC were in anadvanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was takenfor diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondaryprevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lungcancer burden in Kerala.http://journal.waocp.org/article_26905_1e4f4f79f3e17c55301e2b89d5ebcbbd.pdf2012-09-01T11:23:202017-12-14T11:23:2046394643Lung cancerPrevalencetobacco smokingHistologypreventionORIGINAL_ARTICLEMetaplastic Breast Carcinoma: Case Series and Review of the LiteratureMetaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breastcarcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial(carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patientsadmitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5(range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows:5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis,had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most commonsites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium wasplanned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles ofchemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month).Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approachesand the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.http://journal.waocp.org/article_26906_4ff696c4bbd8ecc44db5070bfa99114f.pdf2012-09-01T11:23:202017-12-14T11:23:2046454649Breast metaplastic carcinomarare diseaseorphan statuspoor prognosisORIGINAL_ARTICLEDoes the Success of a School-based HPV Vaccine Programme Depend on Teachers’ Knowledge and Religion? - a Survey in a Multicultural SocietyOrganized introduction of prophylactic human papillomavirus (HPV) vaccination can reduce the burdenof cervical cancer in developing countries. One of the most effective ways is through a national school-basedprogram. Information on teachers is therefore important since this group may have a disproportionate influencein the success of any implementation. Objective: To assess teachers’ knowledge and perception of HPV, cervicalcancer and HPV vaccine prior to commencing a school-based HPV vaccination program in a multiethnic,predominantly Muslim country. Factors associated with acceptability of the vaccine were identified. Method: Abilingual questionnaire was applied to 1,500 secondary school teachers from 20 urban schools in Malaysia. Datacollected were analyzed using SPSS version 17. Results: 1,166 questionnaires were returned. From this group,46.1% had never heard of HPV while 50.9% had never had a pap smear. However, 73.8% have heard of theHPV vaccine with 75% agreeing to have it. 96% considered themselves religious with 79.8% agreeing to havethe vaccine. Conclusions: A national school-based HPV immunization program can be implemented effectivelyin a multiethnic, cultural and religious country despite limited knowledge of HPV-related pathology amongteachers. In addition, the perception that religion has a negative influence on such a program is unwarranted.http://journal.waocp.org/article_26907_a5f689040141986f35ecdf59238a1331.pdf2012-09-01T11:23:202017-12-14T11:23:2046514654HPV vaccineschool-based vaccination programmecervical cancer preventionDeveloping worldORIGINAL_ARTICLEInhibitory Effects of Opuntia humifusa on 7, 12-Dimethylbenz[a]anthracene and 12-O-tetradecanoylphorbol-13-acetate Induced Two-stage Skin CarcinogenesisOpuntia humifusa, member of the Cactaceae family, was previously demonstrated to have radicalscavenging, anti-inflammatory and anti-proliferative effects in in vitro models. It was suggested that O.humifusa could function in the prevention of carcinogenesis. To investigate the in vivo chemopreventiveeffect of O. humifusa, mice were fed a diet containing either 1% or 3% following 7, 12-dimethylbenz[a]anthracene (DMBA) and 12-O-tetradecanoylphorbol-13-acetate (TPA) induction of skin carcinogenesis.Significant decrease in the numbers of papilloma and epidermal hyperplasia were observed in mice fed withO. humifusa, compared to the control group. O. humifusa also upregulated high total antioxidant capacityand level of phase II detoxifying enzyme such as superoxide dismutase and glutathione S-transferase activityin the skin. Lipid peroxidation activity level was measured in skin cytosol and significantly inhibited in 3%OH fed group compared to the control group. These results suggest that O. humifusa exerts chemopreventiveeffects on chemical carcinogenesis in mouse skin and that prevention effects are associated with reduction ofoxidative stress via the modulation of cutaneous lipid peroxidation, enhancing of total antioxidant capacityespecially in phase II detoxifying enzyme system and partial apoptotic influence.http://journal.waocp.org/article_26908_552a8df9e9d6951dceff8dcae5db9672.pdf2012-09-01T11:23:202017-12-14T11:23:2046554660Opuntia humifusaprickly pear fruitSkin CancerOxidative stressORIGINAL_ARTICLEDevelopment of a Sampling Strategy and Sample Size Calculation to Estimate the Distribution of Mammographic Breast Density in Korean WomenMammographic breast density is a known risk factor for breast cancer. To conduct a survey to estimatethe distribution of mammographic breast density in Korean women, appropriate sampling strategies forrepresentative and efficient sampling design were evaluated through simulation. Using the target populationfrom the National Cancer Screening Programme (NCSP) for breast cancer in 2009, we verified thedistribution estimate by repeating the simulation 1,000 times using stratified random sampling to investigatethe distribution of breast density of 1,340,362 women. According to the simulation results, using a samplingdesign stratifying the nation into three groups (metropolitan, urban, and rural), with a total sample size of4,000, we estimated the distribution of breast density in Korean women at a level of 0.01% tolerance. Basedon the results of our study, a nationwide survey for estimating the distribution of mammographic breastdensity among Korean women can be conducted efficiently.http://journal.waocp.org/article_26909_7ba440feb5d439fc557e42327ec42125.pdf2012-09-01T11:23:202017-12-14T11:23:2046614664breast densityhealth surveyMammographysample sizeORIGINAL_ARTICLEFirst Trial of Cervical Cytology in Healthy Women of Urban Laos using by Self-sampling InstrumentCervical cancer is the most common cancer in Laos women and a screening programme, even with the PAPsmear test (PAP test), has yet to be established for routine use. The Pap test is accepted as the most appropriatefor cervical cancer screening in some settings but it is not commonly available in Laos hospitals, because thereare few cytopathologists and gynecologists have little experience. As a pilot program, seminars for the PAPtest were given in 2007 and 2008, and then PAP tests were carried out using self-sampling instrument (Kato’sdevice) with 200 healthy volunteers in Setthathirath hospital, Laos, in 2008. The actual examination number was196, divided into class I 104 (53.1%), class II 85 (43.3%), class IIIa 4 (2.0%), class IIIb 1 (0.5%), and class V 1(0.5%) by modified Papanicalau classification. Four cases had menstruation. There were 6 cases with epithelialcell abnormalities including malignancy. There were 7 cases with fungus and 2 cases with trichomonas in ClassII. More than 70% volunteers felt comfortable with the Kato’s device and wanted to use it next time, becauseof the avoidance of the embarrassment and a low cost as compared with pelvic examination by gynecologists.This first trial for PAP test for healthy Laos women related to a hospital found three percent to have avnormalcervical epithelial cells. Therefore, this appraoch using a self-sampling device suggests that it should be plannedfor cervical cancer prevention in Laos.http://journal.waocp.org/article_26910_fc214c1ee997e26eed9a3ab3c388def0.pdf2012-09-01T11:23:202017-12-14T11:23:2046654667Pap testself-sampling devicecervical canceravoidance of embarrassmentLaosORIGINAL_ARTICLESafety Assessment of Ovarian Cryopreservation and Transplantation in Nude Mice Bearing Human Epithelial Ovarian CancerObjective: Nude mice with orthotopic transplantation of human ovarian epithelial cancer were used toinvestigate screening criteria for paraneoplastic normal ovarian tissue and the security of the freezing andthawing for ovarian tissue transplantation. Methods: Expression of CK-7, CA125, P53, survivin, MMP-2/TIMP-2 in paraneoplastic normal ovarian tissues were detected by RT-PCR as well as immunohistochemistry. Thetissues of the groups with all negative indicators of RT-PCR, all negative indicators of immunohistochemistry,negative expression of CK-7, CA125 and survivin, positive expression of CK-7, CA125 and survivin, cancertissues and normal ovarian tissues of nude mice were used for freezing and thawing transplantation, to analyzeovert and occult carcinogenesis rates after transplantation. Results: When all indicators or the main indicators,CK-7, CA125 and survivin, were negative, tumorigenesis did not occur after transplantation. In addition theoccult carcinogenesis rate was lower than in the group with positive expression of CK-7, CA125 and survivin(P<0.01). After subcutaneous and orthotopic transplantation of ovarian tissues, rates did not change (P>0.05).There was no statistical significance among rates after transplantation of ovarian tissues which were obtainedunder different severity conditions (P>0.05). Conclusion: Negative expression of CK-7, CA125 and survivin canbe treated as screening criteria for security of ovarian tissues for transplantation. Immunohistochemical methodscan be used as the primary detection approach. Both subcutaneous and orthotopic transplantation are safe. Theinitial severity does not affect the carcinogenesis rate after tissue transplantation. Freezing and thawing ovariantissue transplantation in nude mice with human epithelial ovarian carcinoma is feasible and safe.http://journal.waocp.org/article_26911_be9a2592fb46cca4fd5fae743575a3c2.pdf2012-09-01T11:23:202017-12-14T11:23:2046694675epithelial ovarian cancerovarian cryopreservationTransplantationtumor-associated geneORIGINAL_ARTICLENo Association between Egg Intake and Prostate Cancer Risk: A Meta-analysisObjective: Egg consumption has been suggested to increase the risk of colorectal and some other cancers.The present study summarized and quantified the current evidence relating dietary intake of eggs and prostatecancer. Materials and methods: Literature searches were conducted to identify peer-reviewed manuscriptspublished up to July 2012. Twenty manuscripts from nine cohort studies and 11 case-control studies wereidentified. Summary risk estimates with 95% confidence intervals (CIs) were calculated for case-control andcohort studies separately. Results: Neither the case-control not the cohort studies showed any association ofprostate cancer incidence with egg consumption (case-control studies: odds ratio 1.09, 95% CI 0.86-1.31; cohortstudies: relative risk 0.97, 95% CI 0.97-1.07). The results were consistent in subgroup analysis. Furthermore,no association was observed between egg consumption and prostate cancer-specific mortality. Conclusions: Ouranalyses provided no evidence of a significant influence of egg consumption on prostate cancer incidence andmortality. However, more studies, particularly large prospective studies, are needed.http://journal.waocp.org/article_26912_4b757edb5b5a6b532b6975252a5685ba.pdf2012-09-01T11:23:202017-12-14T11:23:2046774681eggsProstate CancerMeta-analysisORIGINAL_ARTICLETransforming Growth Factor Beta-1 C-509T Polymorphism and Cancer Risk: A Meta-analysis of 55 Case-control StudiesAim: To investigate the association of transforming growth factor-beta 1 (TGF-β1) C-509T polymorphismand susceptibility to cancer by means of meta-analysis. Methods: An extensive search was performed to identifyeligible case-control studies investigating such a link. The strength of the association between TGF-β1 C-509Tpolymorphism and cancer risk was assessed by pooled odds ratios (ORs) and 95%confidence intervals (95%CIs)in fixed or random effects models. Results: 55 published case-control studies with a total number of 21,639 casesand 28,460 controls were included. Overall, there was no association between TGF-β1 C-509T and cancer risk inall genetic comparison models (TT vs. CC: OR=1.01, 95%CI=0.89-1.15; T vs. C: OR=1.01, 95%CI=0.94-1.07).However, a stratified analysis by cancer type indicated -509 T allele was significantly associated with decreasedrisk of colorectal cancer (CRC) (TT vs. CT/CC: OR=0.85, 95%CI=0.76-0.95), especially for Caucasians (TT vs.CT/CC: OR=0.83, 95%CI=0.71-0.98) and for population-based studies (TT vs. CT/CC: OR=0.78, 95%CI=0.68-0.89). Conclusion: This meta-analysis suggested that TGF-β1 C-509T polymorphism might contribute to adecreased risk on colorectal cancer susceptibility, especially for Caucasians.http://journal.waocp.org/article_26913_56b7868ff2fe48c8d446400cc81fc18f.pdf2012-09-01T11:23:202017-12-14T11:23:2046834688TGF-β1Polymorphismcancer risk- meta-analysisORIGINAL_ARTICLEGenetic Variation in PDCD6 and Susceptibility to Lung CancerLung cancer is the most common type of cancer and one of the leading causes of death in the world. Geneticfactors play an important role in its development. PDCD6, the encoding gene for programmed cell death protein6, may function as a tumor suppressor gene. Non-small cell lung cancer (NSCLC) contributes about 80% tonewly histologically diagnosed lung cancer patients. To explore the relationship between PDCD6 and NSCLC,we examined two single nucleotide polymorphisms(rs3756712 G/T andrs4957014 G/T, both in the intron region)of the PDCD6gene.A hospital-based case-control study was carried out including 302 unrelated NSCLC patientsand 306 healthy unrelated subjects. Significantly increased NSCLC risk was found to be associated with the Tallele of rs4957014 (P=0.027, OR=0.760, 95%CI=0.596-0.970). The genotype and allele frequencies of rs3756712did not shown any significant difference between NSCLC group and controls (P=0.327, OR=0.879, 95%CI=0.679-1.137). In conclusion, we firstly demonstrated the association between the PDCD6 gene and risk of NSCLC ina Chinese Han population.http://journal.waocp.org/article_26914_f3ddedfa36fe56581ef8b87283b37c96.pdf2012-09-01T11:23:202017-12-14T11:23:2046894693PDCD6Lung cancersingle nucleotide polymorphismORIGINAL_ARTICLEUrinary Concentrations of Human Epidydimis Secretory Protein 4 (He4) in The Diagnosis of Ovarian Cancer: A Case-Control StudyObjective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4)in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovariancancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations andglomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinaryHE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients withearly stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis whereall ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio ofHE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. Whendiscriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations,the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio hadlower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serumconcentration was more accurate for discrimination of patients with benign and malignant ovarian tumors whencompared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinaryHE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations ofhuman epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparablediscriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommendedas a non-invasive ovarian cancer risk assessment method.http://journal.waocp.org/article_26915_052a7cfbca5e5a022967d42d03b1fecd.pdf2012-09-01T11:23:202017-12-14T11:23:2046954698UrineHE4ovarian cancerdiagnostic markerORIGINAL_ARTICLEEffect of Portal Vein Chemotherapy on Liver Metastasis after Surgical Resection of Colorectal CancerObjective: To explore the effect of portal vein chemotherapy on liver metastasis after surgical resection ofcolorectal cancer. Methods: Patients fulfilling the eligibility criteria were assigned to receive either surgery plus1-week continuous infusion of 5-FU (study group) or surgery alone (observational group). Patients in the studygroup received portal vein chemotherapy, whereby 5-FU (1000 mg/d) and heparin (5000 IU/d) infusion wasinitiated from the day of surgery and lasted for 7 consecutive days. Liver metastasis was monitored during fiveyears follow-up postoperatively. Results: Sixty four patients were recruited and assigned to the study group(12 with colon and 20 with rectal cancer) or the control group (10 with colon and 22 with rectal cancer). Livermetastasis rate was 12.5% in study and 25.0% in observational group, the difference being significant (P<0.01).Conclusion: Portal vein chemotherapy could be an effective treatment in preventing liver metastasis after surgicalresection of colorectal cancer.http://journal.waocp.org/article_26916_786350f77fb16dc409fe20793a3d96a7.pdf2012-09-01T11:23:202017-12-14T11:23:2046994701Portal veincolorectal cancerliver metastasisChemotherapypreventionORIGINAL_ARTICLEComparison of Vinorelbine, Ifosfamide and Cisplatin (NIP)and Etoposide and Cisplatin (EP) for Treatment of Advanced Combined Small Cell Lung Cancer (cSCLC) Patients: A Retrospective StudyObjective: To compare efficacy and safety profile of vinorelbine, ifosfamide and cisplatin (NIP) with etoposideand cisplatin (EP) in the treatment of advanced combined small cell lung cancer (c-SCLC). Methods: FromJanuary 2006 to December 2010, 176 patients with advanced c-SCLC were enrolled. The primary endpoint wasoverall survival (OS) and the secondary endpoints were progression free survival (PFS), response rate (RR) andtoxicity. Results: Overall RR was 30.0% in the NIP and 38.5% in the EP group; there was no significant difference(P=0.236). The PFS in the EP group was little longer than that of NIP group, with 6.5 months for EP and 6.0months for NIP group, but the difference was statistically non-significant (P=0.163). The median OS and one yearsurvival rates were 10.4 months and 36.3% for NIP group, and 10.8 months and 49.0% for EP respectively, EPshowing a survival benefit, although this was not statistically significant. Both groups well tolerated the adverseeffects. The incidence of grade I-II leucopenia and alopecia in the NIP group was significantly higher than thatof EP group (32.5% vs. 10.4% (P<0.001, 35.0% vs. 12.5%, P<0.001). Conclusion: the ORR, PFS and OS in NIPwere slightly inferior to traditional regimen EP. The toxicity of NIP can be considered tolerable. The usage ofthree drugs combination in the treatment of mixed SCLC remains uncertain. Nevertheless, the results need tobe further confirmed by large, prospective clinical trials.http://journal.waocp.org/article_26917_296f8966543c19c7bf7f1b57983e5eb8.pdf2012-09-01T11:23:202017-12-14T11:23:2047034706lung neoplasmsCarcinomasmall cellcombined chemotherapyregimenORIGINAL_ARTICLEPrognostic Significance of Annexin A1 Expression in Pancreatic Ductal AdenocarcinomaAnnexin A1 is a 37-kDa calcium- and phospholipid-binding protein of the annexin superfamily considered toplay an important role in tumorigenesis. However, associations with clinicopathological features in pancreaticductal adenocarcinoma (PDAC) cases have yet to be fully defined. We therefore investigated the prognosticvalue of annexin A1 protein as a PDAC biomarker in 83 tumor and matched non-cancerous tissues or normalpancreas tissues. Expression was analyzed using real-time RT-PCR, Western blotting and immunohistochemistry.In non-tumor tissue, myoepithelial cells showed no or weak expression of annexin A1 while expression was strongand sometimes even located in the nuclei of endothelial cells in tumor tissue. High expression was significantlyassociated with advanced stage (P <0.05) and a worse overall survival (P <0.05). These results provide newinsights to better understand the role of annexin A1 in PDAC survival, and might be relevant to prediction ofprognosis and development of more effective therapeutic strategies aimed at improving survival.http://journal.waocp.org/article_26918_3590ceaa406c324b7e8925502f10f853.pdf2012-09-01T11:23:202017-12-14T11:23:2047074712Annexin A1pancreatic ductal adenocarcinomaprognosisORIGINAL_ARTICLEDietary Patterns and Risk of Colorectal Cancer: A Systematic Review of Cohort Studies (2000-2011)Objectives: This systematic review of cohort studies aimed to identify any association between specific dietarypatterns and risk of colorectal cancer (CRC). Dietary patterns involve complex interactions of food and nutrientssummarizing the total diet or key aspects of the diet for a population under study. Methods and materials: Thisreview involves 6 cohort studies of dietary patterns and their association with colorectal cancer. An exploratoryor a posteriori approach and a hypothesis-oriented or a priori approach were employed to identify dietarypatterns. Results: The dietary pattern identified to be protective against CRC was healthy, prudent, fruits andvegetables, fat reduced/diet foods, vegetables/fish/poultry, fruit/wholegrain/dairy, healthy eating index 2005,alternate healthy eating index, Mediterranean score and recommended food score. An elevated risk of CRC wasassociated with Western diet, pork processed meat, potatoes, traditional meat eating, and refined grain pattern.Conclusion: The Western dietary pattern which mainly consists of red and processed meat and refined grainsis associated with an elevated risk of development of CRC. Protective factors against CRC include a healthy orprudent diet, consisting of vegetables, fruits, fish and poultry.http://journal.waocp.org/article_26919_76dc3db983b7051d636af1744438bc7b.pdf2012-09-01T11:23:202017-12-14T11:23:2047134717systematic reviewcolorectal cancerdietary pattern analysisWestern and healthyORIGINAL_ARTICLEFactors Associated with Cervical Cancer Screening Amongst Women of Reproductive Age from Yucatan, MexicoThis study aimed to analyse the participation of women of reproductive age in a cancer screening program,and survey reasons for non-screening in a region from Mexico with high cervical cancer mortality. A total of281 obstetric patients from a previous HPV study in a social security hospital during 2008-2009 were included.Reasons for not participating in the screening were directly asked. HPV positive patients were invited toparticipate in an informative workshop, and they filled in a knowledge questionnaire. The women ranged in agefrom 14-47 years; 123 (43.8%) had never participated in screening, of which 97 (78.9%) had their first sexualintercourse 2 to 10 years ago, resulting in 25% HPV positive. Screening history was strongly associated with 2or more gestations (OR= 10.07, p=0.00) and older age (OR=6.69 p=0.00). When 197 women were contacted andinterviewed, reasons referred for non-screening were ignorance, lack of interest or time, recent sexual onset,shame and fear. More than 50% of the workshop participants showed knowledge of HPV, while 38.9% and 25%knew about Pap smear and cervical cancer. A high percentage of women of reproductive age have never had aPap smear. Promoting the screening program in medical facilities seems to be important in this population. Newapproaches to inform vulnerable individuals on the benefits of screening need to be implemented, especially foryoung women.http://journal.waocp.org/article_26920_039ff7f6f314ebe949a4a29c283d6b2b.pdf2012-09-01T11:23:202017-12-14T11:23:2047194724Young WomenPap testcervical cancer preventionHuman papillomavirusMexicoORIGINAL_ARTICLEGenetic Polymorphism of Glutathione S-transferases M1 and T1, Tobacco Habits and Risk of Stomach Cancer in Mizoram, IndiaAim: The incidence of stomach cancer in Mizoram is highest in India. We have conducted a populationbased matched case-control study to identify environmental and genetic risk factors in this geographical area.Methods: A total of 102 histologically confirmed stomach cancer cases and 204 matched healthy populationcontrols were recruited. GSTM1 and GSTT1 genotypes were determined by PCR and H. pylori infections weredetermined by ELISA. Results: Tobacco-smoking was found to be an important risk factor for high incidenceof stomach cancer in Mizoram. Meiziol (local cigarette) smoking was a more important risk factor than othertobacco related habits. Cigarette, tuibur (tobacco smoke infused water) and betel nut consumption synergisticallyincreased the risk of stomach cancer. Polymorphisms of GSTM1 and GSTT1 genes were not found to be directlyassociated with stomach cancer in Mizoram. However, they appeared to be effect modifiers. Persons habituatedwith tobacco smoking and/or tuibur habit had increased risk of stomach cancer if they carried the GSTM1 nullgenotype and GSTT1 non-null genotype. Conclusion: Tobacco smoking, especially meiziol is the important riskfactor for stomach cancer in Mizoram. GSTM1 and GSTT1 genes modify the effect of tobacco habits. This studyis a first step in understanding the epidemiology of stomach cancer in Mizoram, India.http://journal.waocp.org/article_26921_6ac0efa67e4ec4421673e0ed07454c63.pdf2012-09-01T11:23:202017-12-14T11:23:2047254732stomach cancergenetic polymorphismGSTM1 & GSTT1tobacco habitsMizoramIndiaORIGINAL_ARTICLETobacco-Related Chronic Illnesses: A Public Health Concern for JamaicaBackground: Tobacco use is a leading cause of preventable morbidity and mortality from non-communicablediseases. The objectives of the study were to determine the percentage of annual income used to purchasetobacco-related products and treat tobacco-related illnesses, and assess the characteristics of smokers and theirawareness of the health-related risks of smoking. Method: Stratified and snowball sampling methods were usedto obtain information (via a 17-item, close-ended questionnaire) from 85 adult respondents (49 males and 36females). The instrument comprised of demographic characteristics, smoking behavioural/lifestyle, health, andmicro socio-economics. Results: There were no significant differences between individuals who were affectedby chronic obstructive pulmonary disorder (COPD) (14.1%) and cardiovascular disease (18.8%). It was foundthat respondents spend 30-39% of their annual income on tobacco-related products. Forty percent (40.0%) and41.7% of respondents with lung cancer and COPD respectively spend more than 50% of their annual incometo treat these diseases. The majority (80%) of those who continues to consume tobacco-related products wereuncertain as to why they were doing it. Not all the smokers were aware of the dangers of tobacco consumptiondespite their level of education. Conclusion: The majority of the respondents who had tobacco-related illnessessuch as lung cancer and COPD spend a significant amount of their income on their health care. Not all thesmokers were aware of the dangers of tobacco consumption despite their level of education. This suggests theneed for increase public awareness where both smokers and non smokers are being fully or adequately informedabout the dangers or health risks of tobacco consumption.http://journal.waocp.org/article_26922_6a11015bc5e49cb2e32f004dde5bcd8c.pdf2012-09-01T11:23:202017-12-14T11:23:2047334738TobaccoSmokingIncomerisksConsumptionJamaicaORIGINAL_ARTICLEInvolvement of FoxM1 in Non-Small Cell Lung Cancer RecurrenceBackground: Predictive biomarkers for lung cancer recurrence after curative tumor resection remainunclear. This study set out to assess the role of FoxM1 in the recurrence of non-small cell lung cancer. Methods:Immunohistochemistry for FoxM1 expression was performed on paraffin-embedded tumor tissues from 165NSCLC patients. Association of FoxM1 expression with clinicopathological parameters and disease free survivalwere evaluated. Results: Our results indicated FoxM1 expression to be significantly associated with poorer tissuedifferentiation (P =0.03), higher TNM stage (P <0.01), lymph node metastasis (P <0.01), advanced tumor stage(P <0.01), and poorer disease free survival (P <0.01). Multivariable analysis showed that FoxM1 expressionincreased the hazard of recurrence (hazard ratio= 1.96, 95% CI, 1.04-3.17, P <0.05), indicating that FoxM1is an independent and significant predictor of lung cancer recurrence. Conclusion: Therefore, FoxM1 is anindependent risk factor for recurrence of NSCLC. Elevated FoxM1 expression could be used as an indicator ofpoor disease free survival.http://journal.waocp.org/article_26923_bfb9f3e91f5e1563f3ed811f036e0bd7.pdf2012-09-01T11:23:202017-12-14T11:23:2047394743Lung cancernon-small cell lung cancerFoxM1recurrencepredictive factorORIGINAL_ARTICLEDiagnostic Value of Fluorescence in Situ Hybridization Assay in Malignant Mesothelioma: A Meta-analysisThe diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situhybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed toestablish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of Englishlanguage studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MMwere pooled using random-effects models. Summary receiver operating characteristic curves were applied tosummarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificityfor FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positivelikelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), andthe diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggestthat the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limitedstudies and patients included, further large scale studies are needed to confirm these findings.http://journal.waocp.org/article_26924_3a5faf1ff865aad2dec9d267afbe5932.pdf2012-09-01T11:23:202017-12-14T11:23:2047454749Fluorescence in Situ Hybridizationmalignant mesotheliomaMeta-analysisORIGINAL_ARTICLECombined EGFR and c-Src Antisense Oligodeoxynucleotides Encapsulated with PAMAM Denderimers Inhibit HT-29 Colon Cancer Cell ProliferationColon cancer continues to be one of the most common cancers, and the importance and necessity of newtherapies needs to be stressed. The most important proto-oncogen factors for colon cancer appear to beepidermal growth factor receptor, EGFR, and c-Src with high expression and activity leading to tumor growthand ultimately to colon cancer progression. Application of c-Src and EGFR antisense agents simultaneouslyshould theoretically therefore have major benefit. In the present study, anti-EGFR and c-Src specific antisenseoligodeoxynucleotides were combined in a formulation using PAMAM dendrimers as a carrier. Nano drug entryinto cells was confirmed by flow cytometry and fluorescence microscopy imaging and real time PCR showed geneexpression of c-Src and EGFR, as well as downstream STAT5 and MAPK-1 with the tumor suppressor geneP53 to all be downregulated. EGFR and c-Src protein expression was also reduced when assessed by westernblotting techniques. The effect of the antisense oligonucleotide on HT29 cell proliferation was determined byMTT assay, reduction beijng observed after 48 hours. In summary, nano-drug, anti-EGFR and c-Src specificantisense oligodeoxynucleotides were effectively transferred into HT-29 cells and inhibited gene expression intarget cells. Based on the results of this study it appears that the use of antisense EGFR and c-Src simultaneouslymight have a significant effect on colon cancer growth by down regulation of EGFR and its downstream genes.http://journal.waocp.org/article_26925_7d2f213a80eafcdc318d7f6c9906ecaf.pdf2012-09-01T11:23:202017-12-14T11:23:2047514756Colon cancerHT-29antisenseEGFRc-SrcPAMAM dendrimersORIGINAL_ARTICLEImpact of Low Versus Conventional Doses of Chemotherapy During Transcatheter Arterial Chemo-embolization on Serum Fibrosis Indicators and Survival of Liver Cancer PatientsObjectives: To explore the impact of low- vs conventional-dose chemotherapy via transcatheter arterialchemo-embolization (TACE) on serum fibrosis indicators and treatment efficacy of hepatocellular cancerpatients (HCC). Materials and Methods: Patients fulfilling the eligibility criteria were assigned to TACE inGroup A (with low-dose chemotherapy) or Group B (conventional-dose chemotherapy). Four serum fibrosisrelated indicators, hyaluronic acid(HA), human pro-collagen type-Ⅲ (hPC-Ⅲ), laminin (LN), and collagentype-Ⅳ(Ⅳ-C) before TACE were compared with the values 7 days after TACE. The response rate and survivaltime were also compared between the two groups. Results: Fifty patients with HCC were enrolled in this study,including 25 in Group A and 25 in Group B. No significant differences were detected between the two groups inthe four indicators before TACE. After TACE, the value of the four serum indicators increased significantly inGroup B. However, no significant differences regarding these four indicators were found in Group A after TACE.Significant differences were demonstrated between the two groups after TACE, but median survival time and1 or 2 year overall survival rates did not differ (P>0.05). Conclusions: Low-, compared with conventional-dosechemotherapy exerts the same impact on the variation of fibrosis related indicators and has no influence onmedian survival time and survival rate after TACE in HCC patients.http://journal.waocp.org/article_26926_da081ec4462a87b31700b813f1119255.pdf2012-09-01T11:23:202017-12-14T11:23:2047574761Hepatocellular cancertranscatheter arterial chemo-embolizationfibrosis indicatorsORIGINAL_ARTICLEToll-like Receptor 5 Agonism Protects Mice from Radiation Pneumonitis and Pulmonary FibrosisRadiation pneumonitis and pulmonary fibrosis are the main complications with radiotherapy for thoracicneoplasms, directly limiting the efficient dose in clinical application and currently there are few medicines thateffectively function as radioprotectants. However, a TLR5 agonist, CBLB502, was confirmed to have protectiveefficacy against hematopoietic and gastrointestinal radiation syndromes in mice and primates. This study pointsto a new direction for protection against thoracic radiation-induced pulmonary syndromes and skin injury byCBLB502. We utilized the TUNEL assay, pathological analysis and immunohistochemistry to obtain evidence thatCBLB502 could alleviate the occurrence of radiation pneumonitis and pulmonary fibrosis as well as radiationinducedskin injury. It may thus play a promising role in facilitating clinical radiotherapy of thoracic neoplasms.http://journal.waocp.org/article_26927_fbbfb8969807fe0f5b05430783811297.pdf2012-09-01T11:23:202017-12-14T11:23:2047634767CBLB502radiation pneumonitisPulmonary fibrosisthoracic radiotherapyORIGINAL_ARTICLEHealthy Lifestyle Changes During the Period Before and After Cancer Diagnosis Among Breast Cancer SurvivorsAims: The purpose of the present study was to investigate healthy lifestyle changes during the period beforeand after breast cancer diagnosis in Taiwan. Materials and Method: Lifestyle changes during the period beforeand after cancer diagnosis were assessed by convenience sampling with a structured questionnaire for breastcancer survivors. Results: A total of 235 breast cancer survivors completed the healthy lifestyle scale. The meanvalues before and after breast cancer diagnosis of the participants were 3.27 and 3.73. The final five dimensionsfor the period before breast cancer diagnosis were: had not experienced stress; had exercised; had maintainedsleep quality; had maintained body weight; and had maintained relationships. The final five dimensions for theperiod after breast cancer diagnosis were: sleep quality; had not experienced stress; relationship; had exercised;and had maintained body weight. A paired-t test was applied to examine the differences before and after cancerdiagnosis, revealing that the total average scores of the participants on the healthy lifestyle scale clearly differedstatistically (t= -17.20, p<0.01); and the nine dimensions before and after testing also demonstrate a markedstatistical difference (p<0.01). Conclusions: These findings are helpful in understanding the healthy lifestylechanges during the period before and after cancer diagnosis among breast cancer survivors. It is expected thatthese results can offer references of self-care for this group of patients.http://journal.waocp.org/article_26928_1e60313b32e98b179607fcd959b0eff9.pdf2012-09-01T11:23:202017-12-14T11:23:2047694772breast cancer survivorshealthy lifestylestressRelationshipsExerciseSleep qualitybody weightORIGINAL_ARTICLEClinical Study on Safety and Efficacy of Qinin® (Cantharidin Sodium) Injection Combined with Chemotherapy in Treating Patients with Gastric CancerObjectives: To assess the efficacy, side effects, and the impact on quality of life with Qinin® (Cantharidinsodium) injection combined with chemotherapy for gastric cancer patients. Method: A consecutive cohort of 70patients were divided into two groups: experimental group with cantharidin sodium injection combined withchemotherapy, while the control group received chemotherapy alone. After more than two courses of treatment,efficacy, quality of life and side effects were evaluated. Results: The response rate of experimental group wasnot significantly different from that of the control group (P>0.05), but differences were significant in clinicalbenefit response and KPS score. In addition, gastrointestinal reactions and the incidence of leukopenia werelower than in the control group (P<0.05). Conclusions: Qinin® (Cantharidin sodium) injection combined withchemotherapy enhances clinical benefit response, improving quality of life of gastric cancer patients and reducingside effects of chemotherapy. Thus Qinin® (Cantharidin sodium) injection deserves to be further investigatedin randomized control clinical trails.http://journal.waocp.org/article_26929_cb0f826ef1ba64a98b48513aeb885b73.pdf2012-09-01T11:23:202017-12-14T11:23:2047734776Cantharides sodium injectionChemotherapygastric cancer treatmentORIGINAL_ARTICLEClinical Study of Thalidomide Combined with Dexamethasone for the Treatment of Elderly Patients with Newly Diagnosed Multiple MyelomaObjective: To investigate the relationship between the efficacy and safety of different doses of thalidomide(Thal) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiplemyeloma (MM). Methods: Clinical data of 28 elderly patients with newly diagnosed MM who underwent theTD regimen as the initial therapy were analyzed retrospectively. The patients were divided into two groupsaccording to the maximal sustained dose of Thal: lower dose (group A) and higher dose (group B). The overallresponse rate (ORR), progression free survival (PFS), overall survival (OS), and adverse events (AES) werecompared between the two groups. Results: A total of 28 patients were followed up with a median of 18 months.The ORR was 60.1%. The median response time and PFS were 2.0 and 17.0 months, respectively. The meansustained dose of Thal in group B was significantly higher than group A (292.9 mg v 180.4 mg, P=0.01). Therewas no significantly difference in ORR (57.1% v 64.3%, P=1.00) and PFS (9.63months v 17.66 months, P=0.73)between groups A and B. During the follow up, only five patients died (<40%) and, therefore, median OS valueswere not available. It is estimated, however, that the mean survival time in the two groups was 35.6 and 33.4months (P>0.05), respectively. All of the patients tolerated the treatment well. The incidence of AES in patientswith a grading above 3 in group B was significantly higher than in group A (P=0.033). Conclusions: The TDregimen results in a high response rate and manageable AES as the initial therapy in elderly patients with MM.TD should be considered as the front line regimen for the treatment of elderly patients with MM in areas withfinancial constraints. The clinical response can be achieved at a low dose Thal with minimal toxicity.http://journal.waocp.org/article_26930_76ebbc61fd201e0adac194a1f9e22238.pdf2012-09-01T11:23:202017-12-14T11:23:2047774781Multiple myelomaChemotherapyThalidomidedoseEfficacytoxicityORIGINAL_ARTICLEAssociation Between XRCC1 Gene Polymorphisms and Risk of Glioma Development: A Meta-analysisObjective: Previous studies of the association between X-ray cross-complementing group 1 (XRCC1) genepolymorphisms and the gliomas risk have yielded conflicting results, and thus a meta-analysis was performedto provide a more accurate estimation. Methods: A computerized literature search of 5 electronic databases wasconducted to identify the relevant studies. Fixed or random effect models were selected based on the heterogeneitytest. Publication bias was estimated using Begg’s funnel plots and Egger’s regression test. Results: A total of 11studies (3,810 cases and 6,079 controls), 7 studies (2,928 cases and 5,048 controls), and 4 studies (1,461 cases and2,593 controls) were finally included in the analyses of the association between XRCC1 Arg399Gln, Arg194Trp,and Arg280His polymorphisms and glioma risk, respectively. The pooled results showed that GlnGln carriagewas associated with moderately increased risk of gliomas in Asians (GlnGln vs. ArgArg, OR=1.490, 95%CI1.031-2.153; GlnGln/ArgGln vs. ArgArg, OR=1.321, 95%CI 1.037- 1.684), whereas a marginal association wasrevealed in Caucasians. For the Arg194Trp polymorphism, although a significant association was shown inthe homozygous genotype comparisons (TrpTrp vs. ArgArg, OR = 2.209, 95%CI 1.398- 2.945), no significantlink was found on subgroup analysis stratified by ethnicity. With regard to the Arg280His polymorphism, nosignificant association was found in each comparison. No particular study was found to significantly influencethe pooled results, and no potential publication bias was detected. Conclusions: This meta-analysis suggestedthat the XRCC1 Arg399Gln polymorphism is moderately associated with increased risk of gliomas in Asians,while Arg194Trp and Arg280His polymorphisms demonstrated no significant influence. Due to the limited studiesand the potential confounders, further studies are needed to confirm these results.http://journal.waocp.org/article_26931_8221739a801c5e8c55fdd8aa15e03d1d.pdf2012-09-01T11:23:202017-12-14T11:23:2047834788XRCC1DNA repair geneGliomasGene PolymorphismORIGINAL_ARTICLEUse of Complementary and Alternative Medicine Among Breast Cancer Survivors in TaiwanAims: The purpose of this study was to investigate complementary and alternative medicine use amongbreast cancer survivors in Taiwan. Materials and Methods: This study employed a descriptive research designapproach to detail the CAM use among the target population. Convenience sampling was used along with astructured questionnaire. Results: A total of 230 breast cancer survivors completed the use CAM scale. Prayer,reading books, taking antioxidants, eating various grains, and maintaining a vegetarian diet proved to be thefive most frequently used CAM practices among patients in our study. More than 50.0% of the participantsreported praying occasionally. More than 40.0% of participants read books occasionally, and 38.7% stated thatthey occasionally take antioxidants. Conclusions: These results provide more insight into CAM use for nurseswho care for breast cancer patients.http://journal.waocp.org/article_26932_443cf5b0f355a16b9bb8f7bd266af7fc.pdf2012-09-01T11:23:202017-12-14T11:23:2047894792breast cancer survivorsCAM useTaiwanORIGINAL_ARTICLEMicroarray Analysis of the Hypoxia-induced Gene Expression Profile in Malignant C6 Glioma CellsHypoxia is commonly featured during glioma growth and plays an important role in the processes underlyingtumor progression to increasing malignancy. Here we compared the gene expression profiles of rat C6 malignantglioma cells under normoxic and hypoxic conditions by cDNA microarray analysis. Compared to normoxicculture conditions, 180 genes were up-regulated and 67 genes were down-regulated under hypoxia mimicked byCoCl2 treatment. These differentially expressed genes were involved in mutiple biological functions includingdevelopment and differentiation, immune and stress response, metabolic process, and cellular physiologicalresponse. It was found that hypoxia significantly regulated genes involved in regulation of glycolysis and celldifferentiation, as well as intracellular signalling pathways related to Notch and focal adhesion, which are closelyassociated with tumor malignant growth. These results should facilitate investigation of the role of hypoxia inthe glioma development and exploration of therapeutic targets for inhibition of glioma growth.http://journal.waocp.org/article_26933_42e24e25cf0085d8a6982d69383b9e2c.pdf2012-09-01T11:23:202017-12-14T11:23:2047934799GliomahypoxiamicroarrayDifferentially expressed genesORIGINAL_ARTICLEHealth Behavior after A Multiprofessional Intervention and Training for Ongoing Volunteer-Based Community Health Programme Intervention in the North-East of Thailand: What Changed and What not?This qualitative research within the project entitled “Multiprofessional Intervention and training forOngoing Volunteer-based Community Health Programs in the Northeast of Thailand (MITV-NET)” was aimedat explaining changes of health behavior of community people in the Northeast after the intervention. Theparticipants comprised 15 community volunteers and 27 villagers. Data were collected by indepth interview, focusgroup discussion, participation and non-participation observation, and note taking. Analyses were conducted inparallel with data collection, through content and comparative analysis. It was found that the health behavior fellinto 2 categories: easy-to-change and difficult-to-change. The former involved fun activities joined by communitypeople that improved their health or made them recover from illnesses after a short period without becomingaddicted. These activities could be done by themselves, for example, exercising and cooking. The difficult-to-change health behavior is habitual, for example, chewing betel nuts or eating uncooked food. The followingfactors were found affecting behavioral changes: 1) underlying disease; 2) enjoyment in doing activities; 3)habitual behaviour; 4) improved health in a short period; 5) ability of community leaders and volunteers; and6) community health-supporting resources. It is suggested that improving people’s health requires cooperationof community people through fun activities and some initial external support. People who persist in bad habitsshould be encouraged to stop by showing them health deteriorating effects.http://journal.waocp.org/article_26942_d9e129a218e1d8b2755c8eed539f91b2.pdf2012-09-01T11:23:202017-12-14T11:23:2048014805community-based interventionhealth behaviourExercisefoodNorth-East ThailandORIGINAL_ARTICLECharacterization and Resistance Mechanisms of A 5-fluorouracilresistant Hepatocellular Carcinoma Cell LinePurpose: The chemoresistance of human hepatocellular carcinoma (HCC) to cytotoxic drugs, especiallyintrinsic or acquired multidrug resistance (MDR), still remains a major challenge in the management of HCC.In the present study, possible mechanisms involved in MDR of HCC were identified using a 5-fluorouracil (5-FU)-resistant human HCC cell line. Methods: BEL-7402/5-FU cells were established through continuous culturingparental BEL-7402 cells, imitating the pattern of chemotherapy clinically. Growth curves and chemosensitivityto cytotoxic drugs were determined by MTT assay. Doubling times, colony formation and adherence rates werecalculated after cell counting. Morphological alteration, karyotype morphology, and untrastructure were assessedunder optical and electron microscopes. The distribution in the cell cycle and drug efflux pump activity weremeasured by flow cytometry. Furthermore, expression of potential genes involved in MDR of BEL-7402/5-FUcells were detected by immunocytochemistry. Results: Compared to its parental cells, BEL-7402/5-FU cells hada prolonged doubling time, a lower mitotic index, colony efficiency and adhesive ability, and a decreased drugefflux pump activity. The resistant cells tended to grow in clusters and apparent changes of ultrastructuresoccurred. BEL-7402/5-FU cells presented with an increased proportion in S and G2/M phases with a concomitantdecrease in G0/G1 phase. The MDR phenotype of BEL-7402/5-FU might be partly attributed to increaseddrug efflux pump activity via multidrug resistance protein 1 (MRP1), overexpression of thymidylate synthase(TS), resistance to apoptosis by augmentation of the Bcl-xl/Bax ratio, and intracellular adhesion medicated byE-cadherin (E-cad). P-glycoprotein (P-gp) might play a limited role in the MDR of BEL-7402/5-FU. Conclusion:Increased activity or expression of MRP1, Bcl-xl, TS, and E-cad appear to be involved in the MDR mechanismof BEL-7402/5-FU.http://journal.waocp.org/article_26934_cecc4f7239778740e4e61d902c4e4f33.pdf2012-09-01T11:23:202017-12-14T11:23:2048074814Hepatocellular carcinomaMultidrug Resistance5-FluorouracilATP-binding cassette transportersORIGINAL_ARTICLE(-)-Epigallocatechin-3-Gallate Induces Apoptosis and Inhibits Invasion and Migration of Human Cervical Cancer CellsInvasion and metastasis are the major causes of cancer-related death. Pharmacological or therapeuticinterventions such as chemoprevention of the progression stages of neoplastic development could result insubstantial reduction in the incidence of cancer mortality. (-)-Epigallocatechin-3-gallate (EGCG), a promisingchemopreventive agent, has attracted extensive interest for cancer therapy utilizing its antioxidant, antiproliferativeand inhibitory effects on angiogenesis and tumor cell invasion. In this study, we assessed theinfluence of EGCG on the proliferative potential of HeLa cells by cell viability assay and authenticated theresults by nuclear morphological examination, DNA laddering assay and cell cycle analysis. Further we analyzedthe anti-invasive properties of EGCG by wound migration assay and gene expression of MMP-9 and TIMP-1in HeLa cells. Our results indicated that EGCG induced growth inhibition of HeLa cells in a dose- and timedependentmanner. It was observed that cell death mediated by EGCG was through apoptosis. Interestingly,EGCG effectively inhibited invasion and migration of HeLa cells and modulated the expression of related genes(MMP-9 and TIMP-1) . These results indicate that EGCG may effectively suppress promotion and progressionstages of cervical cancer development.http://journal.waocp.org/article_26935_8cba64c9d66a758384d7d0c9a5625457.pdf2012-09-01T11:23:202017-12-14T11:23:2048154822Epigallocatechin-3-gallateInvasionmatrix metalloproteinases-9cervical cancerORIGINAL_ARTICLEClinical Predictive Value of Serum Angiogenic Factor in Patients with OsteosarcomaObjective: To explore serum angiogenic factor expression in patients with osteosarcoma and its relationshipwith metastasis. Methods: Immunohistochemistry was used to test the expression of CD34 and FⅧ-Rag inosteosarcoma tissues of 36 patients (osteosarcoma group) and microvessel density (MVD) was also recorded.In addition, ELISA was used to test the level of vascular endothelial growth factor (VEGF), basic fibroblastgrowth factor (bFGF), transforming growth factor-β1 (TGF-β1) and endostatin (ES) in the osteosarcoma groupand in a control group. Results: VEGF and ES level were significantly higher than in the control group beforeoperation (P<0.01), VEGF, bFGF and TGF-β1 correlating with the ES level (P<0.01). Serum VEGF and ESlevels of osteosarcoma patients before surgery were closely related to relapse and metastasis; moreover, serumVEGF increased with MVD (P<0.01). Postoperative VEGF and ES levels were lower than the preoperationvalues (P<0.01); ES level in relapse group was significantly higher than that of the non-relapse group (P<0.01).Conclusion: Preoperative serum VEGF and postoperative ES levels have great predictive value with regard torelapse of osteosarcoma patients.http://journal.waocp.org/article_26936_ff98fbe995068a7ca50c80564a8d46fd.pdf2012-09-01T11:23:202017-12-14T11:23:2048234826osteosarcomaangiogenic facormicrovessel densityORIGINAL_ARTICLEGelsolin Induces Promonocytic Leukemia Differentiation Accompanied by Upregulation of p21CIP1Tumor suppressor genes have received much attention for their roles in the development of human malignancies.Gelsolin has been found to be down-regulated in several types of human cancers, including leukemias. It is,however, expressed in macrophages, which are the final differentiation derivatives for the monocytic myeloidlineage, implicating this protein in the differentiation process of such cells. In order to investigate the role ofgelsolin in leukaemic cell differentiation, stable clones over-expressing ectopic gelsolin, and a control clone wereestablished from U937 leukaemia cells. Unlike the control cells, both gelsolin-overexpressing clones displayedretarded growth, improved monocytic morphology, increased NADPH and NSE activities, and enhanced surfaceexpression of the β-integrin receptor, CD11b, when compared with the parental U937 cells. Interestingly, RTPCRand western blot analysis also revealed that gelsolin enhanced p21CIP1 mRNA and protein expression inthe overexpressing clones. Moreover, transient transfection with siRNA silencing P21CIP1, but not the controlsiRNA, resulted in a reduction in monocytic differentiation, accompanied by an increase in proliferation. Inconclusion, our work demonstrates that gelsolin, by itself, is capable of inducing monocytic differentiation inU937 leukaemia cells, most probably through p21CIP1 activation.http://journal.waocp.org/article_26937_4a3db3d0693a1ac349902e57769683c0.pdf2012-09-01T11:23:202017-12-14T11:23:2048274834Gelsolinactinpromonocytic leukemiadifferentiationORIGINAL_ARTICLEHigh Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual DiseaseObjectives: To evaluate residual disease in uterine cervical cancer patients treated with teletherapy usingcombined high dose rate Cobalt-60 brachytherapy. Materials and Methods: A retrospective study of uterinecervical cancer patients, FIGO stages IB-IVB (International Federation of Gynecologists and Obstetriciansrecommendations), treated by radiotherapy alone between April 1986 and December 1988 was conducted andthe outcomes analysed. The patients were treated using teletherapy 50 Gy/25 fractions, five fractions per week tothe whole pelvis together with HDR Cobalt -60 afterloading brachytherapy of 850 cGy/fraction, weekly to pointA for 2 fractions. Results: The study covered 141 patients with uterine cervical cancer. The mean age was 50.0years with a range of 30-78 years. The mean tumor size was 4.1 cm in diameter (range 1-8 cm). Mean follow - uptime was 2.94 years (range 1 month-6.92 years). The overall incidence of residual locoregional disease was 3.5%.Residual disease, according to stage IIB, IIIB and IVA was present in 2.78%, 3.37% and 50.0%. It was notedthat there was no evidence of residual disease in stage IB and IIA cases. Conclusion: Combined teletherapy alongwith high dose rate Cobalt -60 brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions resulted inoverall 3.5% residual disease and a 96.5% complete response. The proposed recommendation for improvingoutcome is initiation of measurements for early detection of disease.http://journal.waocp.org/article_26938_9773529a248546d0d0297f62696ed977.pdf2012-09-01T11:23:202017-12-14T11:23:2048354837Uterine cervical carcinomateletherapyhigh dose rate Cobalt60 brachytherapyresidual diseasesORIGINAL_ARTICLEShould Male Circumcision be Advocated for Genital Cancer Prevention?The recent policy statement by the Cancer Council of Australia on infant circumcision and cancer preventionand the announcement that the quadrivalent human papillomavirus (HPV) vaccine will be made available forboys in Australia prompted us to provide an assessment of genital cancer prevention. While HPV vaccinationof boys should help reduce anal cancer in homosexual men and cervical cancer in women, it will have little orno impact on penile or prostate cancer. Male circumcision can reduce cervical, penile and possibly prostatecancer. Promotion of both HPV vaccination and male circumcision will synergistically maximize genital cancerprevention.http://journal.waocp.org/article_26939_046e10e05afa031cb220a66f114ef774.pdf2012-09-01T11:23:202017-12-14T11:23:2048394842cancermen’s healthWomen’s healthInfectious DiseasesPublic healthsexual healthurologyORIGINAL_ARTICLESpatial -Temporal Biphasic Carcinogenesis - A New Theory of the Cancer SystemCancer is now a worldwide problem. Although we have obtained a deeper understanding of the disease withthe help of the science and technology, we still cannot reach the essence of cancer. Based on the former theoryof carcinogenic and researches, we submit a new theory called “Spatial -Temporal Biphasic Carcinogenesis” toexplain its development from the viewpoints of time and space.http://journal.waocp.org/article_26940_a0191f17212e23613c262555fa0f8c76.pdf2012-09-01T11:23:202017-12-14T11:23:2048434845spatialtemporal biphasic carcinogenictime and spacemulti-biomarkersORIGINAL_ARTICLEChemotherapy Through a Combination of Fasting and Chronopharmacologyhttp://journal.waocp.org/article_26941_bf969485cbba2ba1d9de1226d261acbf.pdf2012-09-01T11:23:202017-12-14T11:23:2048474848